I was planning on writing a fairly short and concise post to reply to someone’s question on this in another thread, but I seem to see the same “How do I shrink my liver” or “How do I lose weight quick for surgery” questions fairly often, and unless I missed over it, I didn’t really see a good explanation post anywhere, so this is my attempt to help anyone with these questions… if it turns out someone already covered this topic, then my apologies.
One of the fastest ways to shrink your liver to get ready for surgery is with a super-low carb diet. Fat, Protein, salt, and even calories don't matter quite as much - it's really all about carbs.
Carbohydrates are basically sugar and starch, and they break down into glucose molecules. When used as energy, carbohydrates become fuel for your muscles and brain. If your body does not have any use for the glucose (for those of us who don't do daily weight training, run marathons, or get regular extensive exercise), it is converted into glycogen and stored it in the liver and muscles as an energy reserve. Your body can store about a half a day's supply of glycogen. If your body has more glucose than it can use as energy, or convert to glycogen for storage, the excess is converted to fat. So, the amount of carbohydrate you eat determines the amount of glycogen stored in the liver and thus, the size. ***
“How does it work?”
A good way to shrink your liver for the short-term is with a diet of less than 30 grams of carbs per day, and preferably only 1/3rd of your day's calories coming from fat. Without eating carbs, you will start draining glycogen from your liver immediately, reducing it’s mass, and as an added bonus, at the same time, your body will start converting fat back into energy and working it off to supplement the missing glycogen (I've lost 24 pounds since May 7th by doing absolutely nothing except going low-carb. A good part of that is, of course, water weight, but more on that below).
Conversely, if you only do a low-fat diet, but continue eating many carbs, you won't get automatic weight loss (or a smaller liver), you will still have to work off your stored fat by either exercising or dramatically reducing your overall caloric intake, because your body does not need to burn stored fat if you have plenty of carbs (and thus, glycogen) coming in to support your energy needs. You must burn 3500 calories to lose one pound of fat, if you go this route. That doesn’t mean you reduce 3500 calories from what you eat now, it means, you have to eat 3500 less than your body actually burns, and if you sit on your ass all day, as I do, your body doesn’t burn much, trust me.
I should mention, the goal here isn't to burn a bunch of fat, it's just to shrink your liver by not storing glycogen, and to lose any weight required by your doctor or insurance company pre-op. This diet will help you burn fat the longer you stay on it, but initial weight-loss is mostly water weight. More on that below.
(Please realize though, a low-carb diet is not necessarily healthy long-term, see A Low-Carb Diet is Wrong for further explanation)
When you start a low-carb diet, you'll probably find that your daily calorie intake also drops, even if you still eat a large quantity of food. That's because a lot of low- or no-carb foods actually tend to be low in calories as well. A huge three-egg (or even four-egg!) omelet filled with onions, mushrooms, bell peppers and cheese will only run you a few hundred calories, and very few carbs (about 5 or so total).
“Are there any short term side-effects?”
Well, I’m definitely not a doctor, so I can’t tell you ‘no’ for sure. But I can say from my experience this past month, there are only two things I noticed, and both have to do with what comes out of your body more than what goes into it (be forewarned)…
The first week or so, I peed more than I think I ever have in my entire life. I swear, I was going to the bathroom once an hour. Actually, I was a bit worried until I Google’d it and found out that this is because glycogen contains large amounts of water, so burning glycogen leads to the release of water and increased urination.
Also, I had fairly soft, almost diarrhea-like BMs for the first couple of weeks until my body adjusted. This is for the same reason noted above.
Other than that, I’ve had no short-term problems that I know of. No fatigue or lack of energy so long as I kept protein in my diet, and everything else seemed normal.
There can be long-term side effects if you decide to make this a permanent eating plan (see this site for explanation), but let’s be honest, none of us want to live a life without yummy carbs forever, right? So this probably shouldn’t be a big problem for us.
“Cool, I’ll just stop eating bread!”
That's a good start, but it's not good enough. You must research and watch your labels - fruits, many vegetables (squash, tomatoes, corn, etc), milk, yogurt, many other dairy products (except most cheeses, from what I’ve seen, I don’t know why), salad dressings, and any sugar-containing condiments like ketchup, barbeque sauce, relish, etc, all contain many carbs. It's not just about bread and Pasta. And that’s only the tip of the iceberg!
One cup of milk is 13 carbs (no, I don’t mean ‘cup’ like the big-a$$ cups you drink out of at dinner, I mean a measuring cup – 8oz)! That’s half your day’s allotment right there. A yogurt can run you from 20-40 carbs, depending on brand. One cob of corn is 30 carbs, a tomato is 5, salad dressings average about 5 per tablespoon, a simple and healthy apple is still 25-35 carbs, and don’t even think about having a glass of orange juice.
Also, check the labels on those prepackaged foods advertised as 'low-carb'. By USDA guidelines, they may be allowed to advertise as low-carb, but that doesn’t necessarily mean they’re low enough for YOU. A "low-carb" ice cream bar is still 8 grams of carbs - nearly a third of your allowed daily intake just for one wimpy little desert that doesn’t even taste good!
“Fine, I need to shrink my liver, and I’m going to use a low-carb diet to do it. Well, where do I start?”
The first thing to do that will really help you is to start a daily carb count list. This can be a big, dramatic Excel spreadsheet or a simple list on a piece of scrap paper, but either way, it will help you keep track of what you’re really eating, and help you make sure you’re really sticking to your limit. You just need some place where you can write down the number of carbs you’ve eaten for the day so that when the nighttime munchies come around and that gross low-carb ice cream bar is starting to sound really good, you can see that you already hit your carb limit for the day and grab a piece of cheese or a hard-boiled egg instead.
I use a fairly simple excel spreadsheet myself, and I only track calories, fat, and carbs because that's really all I'm worried about right now. At the bottom of each column, a “Daily Totals” row has a basic formula that adds all my entries together and gives me a total for the day. It’s simple enough for me and not too much fuss. This is an example of my spreadsheet:
(Don’t use my meals here as an example though, I’m still a bit too high on fat, and need to be a bit better at cutting back on it.)
The second thing to do is to start reading the labels on everything you put in your mouth – and I mean EVERYTHING! I know it sounds harsh, but remember, this will only be short-term. If you stay on track now, you won’t have to live this way for the rest of your life.
Check out the carb count for all your packaged food, and for any fresh or unlabeled food, look it up online. Here are a couple good websites to help you out:
- Carb Counter on about.com
- My favorite nutritional guide, Eddie on Everything, is currently down as I write this post, but I’m including it just in case it’s just a temporary glitch and it comes back up. If it does, this is a fabulous resource.
Also, don’t forget to include everything you drink on your daily tracker also. Fruit juice, milk, hot chocolate, and especially soda can include an entire day’s carbs – or even more! – in just one serving.
If you must, at least go for diet/sugar-free soda, but if you can handle just sticking to water for the time being, that’s the best. This is a good thing to train yourself on before your surgery anyway, as drinking liquid calories after surgery can really sabotage all your other hard work and keep you from losing weight.
Also, stay away from coffee drinks with milk – lattes, mochas, etc. If you absolutely must have your caffeine hit, drink tea or drip coffee and watch the carbs on any cream and sugar you use.
“I can't do this! Everything I like has carbs in it!”
Okay, hold up, don’t get too discouraged yet. Remember, this isn’t forever. Besides, there are lots of good things to eat that will keep you on track. You just have to think a little harder about it. Here’s some ideas:
- A cup of cottage cheese and a hard-boiled egg or two.
- Scrambled eggs (with just a tiny bit of milk mixed in) or an omelet with some chopped onions, a bit of bacon crumbled in (just watch the fat) or a few slices of lunch meat ham cut up in pieces, a chopped bell pepper, and some shredded cheddar or colby jack cheese mixed in or melted on top.
- A 6 oz can of tuna fish with a little mayo, a small bit of relish (watch the carb count on it), some shredded cheese and maybe a bit of diced cucumber mixed in. Eat it like a salad instead of on bread.
- Shredded or diced chicken mixed with some cream cheese (the 1/3 less fat Neufchatel kind is really good! I like it even better than regular cream cheese) or a couple Laughing Cow cheese soft wedges and spooned onto cucumber slices. Try English cucumbers, they have zero carbs, a thinner and better-tasting skin than normal cucumbers, and very few seeds.
- Taco salad with no chips or tortilla shell. Use sour cream instead of salsa – there’s more fat, but salsa has lots of carbs.
- A big, huge, lean steak with some salad or veggies on the side. Check the carbs on the salad dressing, but don’t think you can’t have any at all. Just make sure you stay within your daily limit.
- Grilled chicken or salmon with some veggies on the side (just make sure they’re lower-carb veggies like asparagus, steamed cabbage, steamed or grilled bell peppers, etc. Helpful hint – butternut squash is not only delicious, it’s also the only squash with virtually no carbs, so go crazy!) and a sugar free jello cup or two for dessert.
Also, remember, this isn’t famine time. Go ahead and put some butter on your veggies, just don’t go crazy. A quarter-cup of butter isn’t going to taste any better than a tablespoon will. Trust me…
Oooh, helpful hint... a company called Walden Farms makes a bunch of no-calorie, no-fat, no-sugar, no-carb, no-glucose condiment type items that actually taste really good! Salad dressings, mayo, fruit spreads, pasta sauces, dessert things like a really yummy chocolate syrup, etc. (The only thing I DON’T recommend is the peanut butter. Trust me on this, it’s not good.) They’re a bit pricy, usually about $4 or $5 an item at the grocery store, but if you can afford it, I highly recommend them. They taste really good, and they’re practically nothing but air. When I eat salads, I’m one of those people who likes to drench my salad in dressing. But let me tell you… 4 or 5 tablespoons of regular dressing with 10 grams of fat and 5 carbs each tbs sure adds up quick. Walden Farms is a much happier option for me.
Check them out at their Walden Farms Website.
The last thing to remember is not to beat yourself up too much. Yes, you really do have to be careful while you’re on this diet. But like everything else in life, if something goes wrong and you fall off the wagon, one bite, one meal, one day, remember tomorrow is a new start. Wake up, start over, and remember than your best effort is better than no effort at all.
Well folks, that’s all I’ve got on the top of my head right now. Hopefully this post will help someone out there. If you have questions, or if there’s any big topic that I missed, let me know, otherwise, I wish all of you the very very best on your journeys!
***most of this paragraph was copied from this page. It provided a better explanation than I came up with on my own. This isn’t an attempt to steal someone else’s writting and claim it as my own.
Edited by SeattleSweetie, June 1, 2008 - 2:21 AM.