Diabetes Exchange Diet

by Maria Adams, MS, MPH, RD The diabetes exchange system can help you select the right amount of different types of foods to eat each day. Eating a well-balanced diet will help your blood sugar stay within a healthy range. The Exchange CategoriesThe exchange system groups foods into one of six categories: starches, meat and meat substitutes, vegetables, fruits, milk, and fats. There are also some foods that are considered free foods because they contain such a low amount of calories and/or carbohydrates.Serving for serving, foods in each of these categories have similar amounts of carbohydrate, protein, and fat. This means that each food in a particular category can be exchanged for another food in that same category.Many foods are made up of more than one food category, so they will not fall nicely into just one of the diabetes exchange categories. These types of foods are known as combination foods. Points to ConsiderThe number of servings, or exchanges, from a category that you can consume each day depends on how many calories you need. A dietitian can help you determine your nutrition needs, including total calories and proportion of carbohydrates, fats, and protein that you should be consuming each day.The key to mastering the diabetes exchange system is becoming familiar with the serving sizes for each category, and also how much carbohydrate, protein, and fat the foods in each category typically contains.Distribute your exchanges over the course of a day and be consistent about following this pattern everyday. This will spread out the amount of carbohydrates that you are consuming, which will help regulate your blood sugar.The foods listed below in the starch, fruit, and milk categories contain the same amount of carbohydrates per serving, 15 grams. Since they have similar effects on your blood sugar, these foods can also be exchanged because they are generally considered carbohydrate servings. For example, you may trade 1 starch serving for 1 fruit or milk serving. A common misconception is that at any given meal, you are limited to eating only the serving sizes listed below, which many people consider small. The exchange system is not quite that restrictive. For example, cup mashed potato counts as 1 serving of starch, or 1 carbohydrate serving. But if you are allotted 3 servings of carbohydrate at dinner, you could skip other starches, fruits and milks, and choose to have all of your carbohydrate as potato. Thus you would eat 1 cups of mashed potato. Nonetheless, this is probably a restriction for most people, but perhaps not quite as restrictive as it first may appear.The exchange system is helpful not only in diabetes, but also for regulating weight. The Exchange ListsThe below tables show each of the different exchange categories, the amount of carbohydrates, protein, fat, and calories one serving of a particular category provides, and examples of different foods and their portion sizes for each category.

Starches_____ servings per dayOne starch exchange = 15 grams carbohydrate, 3 grams protein, 0-1 grams fat, 80 caloriesTypeOne Exchange/ServingBagel (varies), 4 ounces of a bagel (1 ounce)Bread (white, pumpernickel, whole wheat, rye)1 sliceBread, reduced calorie or lite2 slicesBroth-based soup1 cupCooked beans, peas, or corn cupCooked cereal cupCrackers4-6English muffin, hot dog bun, or hamburger bunPasta, rice1/3 cupPopcorn, air popped, no fat added3 cupsPotato1 small (3 ounces) or cup mashedPretzels ounceSweet potato or yam cupTortilla1 smallUnsweetened, dry cereal cupFiber is what makes one carbohydrate better than another. Remember to choose higher fiber breads and bread products for a better effect on your blood sugar. Non-Starchy Vegetables_____ servings per dayOne vegetable exchange = 5 grams carbohydrate, 2 grams protein, 0 grams fat, and 25 caloriesTypeOne Exchange/ServingCooked vegetables cupRaw vegetables1 cupTomato or vegetable juice cupThree servings of non-starchy vegetables add up to one serving of carbohydrate, meaning a bread, fruit, or milk exchange. For example, if you eat a large salad with 3 cups of vegetables, you should count that as 1 serving of carbohydrate. Fruits_____ servings per dayOne fruit exchange = 15 grams carbohydrate, 0 grams protein, 0 grams fat, and 60 caloriesType