The Diabetic Exchange List (Exchange Diet)

The Diabetic Exchange Lists represent food choices a diabetic can make that are similar enough in nature to be exchanged for other foods on the list.  This is a meal planning system for diabetics that was created by a committee of the American Dietetic Association and the American Diabetes Association for diabetics who want to use diet as a means of controlling their blood sugar levels.

The exchange list was created mainly for those individuals who suffer from type 1 or type 2 diabetes; however, it can be used by anyone who needs a particular diet and even those who want to eat healthy foods as part of their daily diet plan. The foods on the exchange list are all basically healthy for you and can be used by anyone.

The exchange list divides foods into six different food groups that are different when it comes to their fat, protein, carbohydrate, and calorie counts.  Each item on the exchange list consists of foods that are similar to one another.  Each item on a food exchange list contains foods that are basically the same when it comes to their fat, protein, carbohydrate, and calorie counts when compared to other foods on the list.

When using the exchange list as part of your meal plan, you will likely see that the choices vary in the amount of food you can eat. This is because the exchange list is based on the weight of the food and some foods weigh more than others but have the same amount of nutrients when compared to other foods on the list.

The Food Types on the Exchange List

The different types of food on the exchange list includes the following:

• Starches and breads
• Meat (which is divided into very lean, lean, medium-fat, and high-fat categories)
• Vegetables
• Fruits
• Milk (which is divided into skim, low fat, and whole milk products)
• Fat

Foods that can be exchanged with one another in each of these categories have differing amounts of fiber in them.  When you read the exchange list, there will be symbols indicating which foods are high in fiber.  It is expected that you try to eat those foods that are the highest in fiber as fiber binds sugars you eat and will allow for a slower absorption of glucose from your gastrointestinal system.

There is also a symbol indicating those foods that are high in sodium content (greater than 400 mg of sodium per serving).  It is expected that you try to avoid those foods that are high in sodium as high sodium foods can make blood pressure worse.  Many diabetics already have high blood pressure and should eat a low sodium as well as a low carbohydrate diet.

Not every food is listed on the exchange list.  If you have a food that you like that isn’t on the list, check with a nutritionist or dietician to see if the food you like can be exchanged with a food on the list. The nutritionist or dietician will determine the fat, protein, carbohydrate, and calorie levels in the particular food and can help you decide how much of the food constitutes a serving size of the food you like.  You might find that the food is not good for you and shouldn’t be eaten.

The Carbohydrate Exchange List

This is the starch and bread list.  Each food item in the list contains about 15 grams of carbohydrates, trace fat amounts, 3 grams of protein, and 80 calories.  Whole grain breads and starches are higher in fiber than things like white bread and white pasta.  For this reason, they should be chosen over the lower fiber food.

If you want to eat a food from the carbohydrate (starch and bread) list that isn’t on the list, you can estimate how much to take by noting that one serving size of starchy food is about one half cup of pasta, grains, or cereal or about one ounce of bread.

Examples of food on this list include grains, cereals, and pasta.  About a half cup of bulgur, cooked cereal, Grape Nuts, and cornmeal can be substituted for each other. The same is true of unsweetened cereals, pasta, rice, and shredded wheat products.

Beans, lentils, and peas are on the carbohydrate exchange list.  You can eat black-eyed peas, split peas, white beans, and kidney beans, which can be exchanged for one another.  About a half cup of each of these foods is a serving.  Potatoes can be exchanged but only if you choose a small baked potato.

Other foods you can exchange include bread, crackers, chow mein noodles, pancakes, stuffing, French fries, taco shells, waffles, and popcorn.

Meat Exchange List

The amount of meat you can eat per serving is about 3 ounces; however, if the meat item is high fat, a serving size of this type of food will be less because of the high fat content.  Each serving on the meat list contains 7 grams of protein and varying amounts of calories and fat, depending on which selection you make.  The meat exchange list is divided into very lean meat, lean meat, medium fat meat, and high fat meats. The idea is to choose mostly very lean and lean meats so you can eat more without having the high fat content of higher fat meats.

You should also consider grilling, broiling, roasting, or baking your meant rather than cooking them with fat as there is less fat and calories in meats that are cooked without using fat.  Trim off any fat that is visible before cooking and cook your meats without breading them or coating them in mixes.  Three ounces of cooked meat is about the same as 4 ounces of raw meat so you can weigh your meat before and after cooking to determine the serving size.

The Vegetable Exchange List

There are a variety of foods you can choose from when exchanging vegetables.  Each serving has about 5 grams of carbohydrates, 25 calories, and 2 grams of protein.  Most vegetables contain 2-3 grams of fiber per serving.  It is recommended that you eat most of your vegetables raw or frozen rather than canned vegetables, which can be high in sodium.  Raw and frozen vegetables are also higher in nutrients when compared to canned vegetables.

A serving size of vegetables is one half cup.  If using canned vegetables, you should rinse them to get off as much sodium as possible.  If you are drinking vegetable juice, a cup is considered one serving size.  You can choose from just about any vegetable except for starchy vegetables, which are included as part of the starch and bread group.

The Fruit Exchange List

Each fruit on the exchange list contains about 15 grams of carbohydrates, very little protein, and 60 calories per serving.  If you choose fresh, frozen, or dry fruits, you can expect to consume about 2 grams of fiber per serving.  Some fruits are higher in fiber and should be considered better choices than low fiber fruits.  A half cup of fruit is considered a single serving and a fourth cup of dried fruit is considered one serving.  Whole fruit is better than drinking fruit juices as they are more filling and have more fiber in them.

The Milk Exchange List

Each item on the milk exchange list contains about 12 grams of carbohydrates and 8 grams of protein.  They contain varying amounts of fat, depending on the type of milk product you choose.  You can choose from skimmed milk, low fat milk, and whole milk.  Milk contains plenty of calcium per serving and you can substitute yogurt over milk.

The Fat Exchange List

Each serving on the fat list contains about 5 grams of fat and 45 calories.  Most of the foods in this exchange list are pure fat although a few items have some protein in them.  All of the foods in the fat exchange list are high in calories so they need to be measured carefully before eating them.   Unsaturated fats are considered better for you than saturated fats.  Fats include butter, margarine, seeds, nuts, salad dressings, coconut, and mayonnaise.

There are some foods that are considered free foods because they contain less than 20 calories per serving.  Anything on the free food exchange list can be eaten in any amount as they don’t add many calories to the diet.  Free foods include sugar free carbonated beverages, coffee, and many low calorie vegetables.

References:

The Diabetic Exchange List (Exchange Diet). http://glycemic.com/DiabeticExchange/The%20Diabetic%20Exchange%20List.pdf