Exchange Diet for Diabetes



The exchange diet divides the foods to groups that contain roughly the same mix of carbohydrates, protein, fat, and calories.
There are six main groups:

  • Bread
  • Meat
  • Vegetables
  • Fruit
  • Milk
  • Fat

Below you can see the table with the list of each group.
Each list contains foods that are alike, i.e., each food choice on a list contains about the same amount of carbohydrate, protein, fat, and calories as the other choices on that list.
The basic unit is a serving which is well defined so that each food from its list will have the same amount of carbohydrate, fat, and protein as any other.
The amount of every food in the right column on the list is 1 serving which is the common denominator.
Now, what you have to do is to "exchange" foods or trade with other foods from the same list while still keeping nutrition values.
Each meal is composed of foods from the exchange lists of every group.
Notice, in the second table below, that the amount of servings of each group is well defined and final.
For changing these amounts, according to your calorie needs, your weight, height, age, and your activity, you should talk with your dietitian.
The exchange diet lists were designed in the first place for people with diabetes and others who have to keep special diets by the American Diabetes Association in cooperation with the American Dietetic Association.

The following chart shows the amounts of nutrients in one serving from each exchange diet list.

GroupCarbohydrate
(gr.)
Protein
(gr.)
Fat
(gr.)
Calories
Bread/Starch153trace80
Meat
Very Lean -70-135
Lean-7355
Medium-Fat-7575
High-Fat-78100
Vegetables52-25
Fruit15--60
Milk
Skim1280-390
Low-Fat1285120
Whole1288150
Fat--545


The following chart shows the recommended combination of the exchange diet list of 1600 calories of food consumption for one day.

GroupNumber of Servings
Per 1 Day
Calories in
1 Serving
Total
Calories
Bread/Starch780560
Meat (very lean)735245
Vegetables625150
Fruit460240
Milk (skim)390270
Fat345135
Total30 1600


The amount of every food in the right column on the lists below is equal to 1 serving.

BREAD/STARCH   LIST

Each item in this list contains approximately 15 grams of carbohydrate, 3 grams of protein, and a trace of fat per serving.
Each item contains 80 calories.
The numbers on the right indicate the serving size for the exchange diet.

BREAD
Bagel1/2 (1 oz)
Bread reduced-calorie2 slices (1 1/2 oz)
Bread-white, wheat, rye1 slice (1 oz)
Bread sticks, crisp 4 inches long, 1/2 inch thick, 2 (2/3 oz)
English muffin1/2
Frankfurter or hamburger bun1/2 (1 oz)
Pita, 6 inches across1/2
Plain roll, small1 (1 oz)
Raisin, unfrosted1 slice (1 oz)
Tortilla, 6 inches across1
STARCHY VEGETABLES
Corn1/2 cup
Corn on the cob, 6-inch1
Peas, green1/2 cup
Potato, baked or boiled1 small (3 oz)
Potato, mashed1/2 cup
Squash, winter (acorn or butternut)1 cup
Yam, sweet potato, plain1/2 cup
Baked beans1/3 cup
CEREALS, GRAINS, PASTA
Bran cereals1/2 cup
Bulgur1/2 cup
Cooked cereals1/2 cup
Cornmeal, dry3 tbsp
Grape-Nuts1/4 cup
Grits, cooked1/2 cup
Cereals, unsweetened3/4 cup
Cereals, sugar-frosted1/2 cup
Pasta, cooked1/2 cup
Puffed cereal1 1/2 cup
Rice, white or brown (cooked)1/3 cup
Shredded wheat1/2 cup
Wheat germ 3 tbsp
CRACKERS, SNACKS
Animal crackers8
Graham crackers, 2 1/2 inches3
Matzoth3/4 oz
Melba toast4 slices
Oyster crackers24
Popcorn (popped, no fat added)3 cups
Pretzels3/4 oz
Rice Cakes, 4 inches across2
Saltine-type crackers6
Whole wheat crackers (no fat)2-5 (3/4 oz)
STARCHY FOOD PREPARED WITH FAT
(Count as 1 starch/bread serving plus 1 fat serving)
Biscuit, 2 1/2 inches across1
Chow-mein noodles1/2 cup
Corn bread, 2 inch cube 1 (2 oz)
Cracker, round butter type6
Croutons1 cup
French fried potatoes16-25 (3 oz)
Granola1/4 cup
Muffin, plain, small1
Pancake, 4 inches across2
Stuffing, bread (prepared)1/3 cup
Taco shell, 6 inches across2
Waffle, 4 1/2 inches square1
Whole wheat crackers (fat added)4-6 (1 oz)
Popcorn, microwave3 cups
Sandwich crackers, peanut butter3


Exchange diet can be applied to most any eating situation and may make it easier to follow a prescribed diet.
For example, if a nutrition plan calls for one bread exchange a person could choose 1/2 cup of cooked pasta, OR one slice of bread, OR a small (3 oz.) baked potato.

MILK LIST

Each item in this exchange diet list contains approximately 12 grams of carbohydrate, 8 grams of protein, and the fats are divided into 3 main groups: skim and very low fat milk, low fat milk, and whole milk.

SKIM AND VERY LOW-FAT MILK
(One exchange contains 12 grams of carbohydrate, 8 grams of protein, 0-3 grams of fat and 90 calories.)
Skim milk1 cup
1/2% milk1 cup
1% milk1 cup
Nonfat or low-fat buttermilk1 cup
Evaporated skim milk1/2 cup
Dry nonfat milk1/3 cup
Plain nonfat yogurt3/4 cup
low fat fruit-flavored yogurt with non-nutritive sweetener1 cup
LOW-FAT MILK
(One exchange contains 12 grams of carbohydrate,8 grams of protein, 5 grams of fat and 120 calories.)
2% milk1 cup
Plain low-fat yogurt3/4 cup
WHOLE MILK
(One exchange contains 12 grams of carbohydrate,8 grams of protein, 8 grams of fat and 150 calories.)
Limit choices from the whole milk category as much as possible.
Whole milk1 cup
Evaporated whole milk1/2 cup
Goat’s milk1 cup


FRUIT LIST

Each item on this exchange diet list contains about 15 grams of carbohydrate and 60 calories.
Fresh, frozen and dry fruits have about 2 grams of fiber per serving.
Fruit juices contain very little dietary fiber.
Use fresh fruits or fruits frozen or canned without added sugar.
Unless stated otherwise, the serving size for one fruit exchange diet may include 1/2 cup of fresh fruit or fruit juice or 1/4 cup of dried fruit.

FRESH FRUIT
Apple (raw, 2 inches across)1 apple
Applesauce (unsweetened)1/2 cup
Apricots (medium, raw)4 apricots
Apricots (canned)1/2 cup
Banana (small)1 banana
Blackberries (raw)3/4 cup
Blueberries (raw)3/4 cup
Cantaloupe (5 inches across)1/3 melon
Cantaloupe (cubes)1 cup
Cherries (large, raw)12 cherries
Cherries (canned)1/2 cup
Figs (raw)1 1/2 large or 2 medium
Fruit cocktail (canned)1/2 cup
Grapefruit (large)1/2 fruit
Grapefruit, segments3/4 cup
Grapes (small)17 grapes
Honeydew (medium)1 slice (10 oz)
Honeydew (cubes)1 cup
Kiwi (large)1 fruit
Mandarin oranges3/4 cup
Mango (small)1/2 mango or 1/2 cup
Nectarine (small)1 nectarine
Orange (small)1 orange
Peach (medium)1 peach 3/4 cup
Peaches (canned)1/2 cup 2 halves
Pear1/2 large
Pears (canned)1/2 cup 2 halves
Pineapple (raw)3/4 cup
Pineapple (canned)1/2 cup
Plums (small)2 plums
Raspberries (raw)1 cup
Strawberries (raw, whole)1 1/4 cup
Tangerine (small)2 fruits
Watermelon, cubes1 1/4 cup
DRIED FRUIT
Apples4 rings
Apricots8 halves
Dates3 medium
Figs1 1/2
Prunes3 medium
Raisins2 tbsp
FRUIT JUICES
Apple juice/cider1/2 cup
Cranberry juice cocktail1/3 cup
Cranberry juice cocktail, reduced-calorie1 cup
Grapefruit juice1/2 cup
Grape juice1/3 cup
Orange juice1/2 cup
Pineapple juice1/2 cup
Prune juice1/3 cup
Fruit juice blends, 100% juice1/3 cup


MEAT  AND  MEAT  SUBSTITUTE  LIST

Each serving of meat and substitute on this exchange diet list contains about 7 grams of protein.
The amount of fat and calories varies, depending on the choice.
The list is divided into very lean meat, lean meat, medium-fat meat and high-fat meat.
One meat exchange diet can be one of the following: 1 ounce of meat, 1 ounce of poultry, 1 ounce of fish, 1 ounce of cheese, 1/2 cup of dried beans.

VERY LEAN MEAT
(One exchange diet has 7 grams of protein, 0-1 grams fat and 35 calories
and equals any one of the following items.)
Poultry
Chicken or turkey (white meat no skin)1 oz
Cornish hen (no skin)1 oz
Fish
Fresh or frozen cod1 oz
Flounder1 oz
Haddock1 oz
Halibut1 oz
Trout1 oz
Tuna, fresh or canned in water1 oz
Shellfish, imitation shellfish1 oz
Clams, crab, lobster, scallops, shrimp1 oz
Game
Duck or pheasant (no skin) 1 oz
Venison1 oz
Buffalo1 oz
Ostrich1 oz
Cheese with 1 gram or less fat per ounce1/4 cup
Nonfat or low-fat cottage cheese1/4 cup
Fat-free cheese1 oz
Meat sandwich with 1 gram or less fat per ounce1 oz
Meat sandwich, deli thin1 oz
Meat (shaved), chipped beef, turkey ham1 oz
Egg whites2
Egg substitutes, plain1/4 cup
Hot dogs with 1 gram or less fat per ounce1 oz
Kidney (high cholesterol)1 oz
Sausage with 1 gram or less fat per ounce1 oz
Count as one very lean meat and one starch exchange
Dried beans, peas, lentils (cooked) 1/2 cup
LEAN MEAT
(One exchange diet has 7 grams of protein, 3 grams of fat, 55 calories
and equals any one of the following items.)
Beef
USDA Select or Choice grades of trimmed lean round1 oz
Sirloin and flank steak1 oz
Tenderloin1 oz
Roast (rib, chuck, rump) 1 oz
Steak (t-bone, porter house, cubed) 1 oz
Ground round1 oz
Pork
Lean pork1 oz
Fresh ham, canned, cured, or boiled ham1 oz
Canadian bacon1 oz
Tenderloin1 oz
Center loin chop1 oz
Lamb
Roast 1 oz
Chop1 oz
Leg1 oz
Veal
Lean chop1 oz
Roast1 oz
Poultry
Chicken (white meat with skin) 1 oz
Chicken (dark meat, no skin) 1 oz
Turkey (dark meat, no skin) 1 oz
Duck or goose, domestic (well drained of fat, no skin)1 oz
Fish
Oysters6 medium
Tuna (canned in oil, drained) 1 oz
Herring1 oz
Salmon (fresh or canned), catfish1 oz
Sardines (canned) 2 medium
Wild Game
Goose (without skin), rabbit1 oz
Cheese
Cottage cheese (4.5% fat) 1/4 cup
Grated parmesan2 tbsp
Diet cheeses (3 grams fat or less)1 oz
Other
Hotdogs with 3 grams or less fat/ounce1 1/2 oz
Luncheon meat with 3 grams or less fat/ounce1 oz
MEDIUM FAT MEAT
(One exchange diet has 7 grams of protein, 5 grams of fat, 75 calories
and equals any one of the following items.)
Beef(Most beef products fall into this category)
Beef, ground1 oz
Meatloaf1 oz
Corned beef1 oz
Short ribs1 oz
Prime grades of meat trimmed of fat, prime rib1 oz
Pork
Chops1 oz
Top loin1 oz
Boston butt1 oz
Cutlets1 oz
Lamb
Rib1 oz
Roast1 oz
Ground1 oz
Veal
Cutlet (unbreaded)1 oz
Poultry
Chicken (dark meat with skin)1 oz
Turkey, ground1 oz
Chicken, ground1 oz
Fried chicken (with skin)1 oz
Fish Any fried fish product1 oz
Cheese (With 5 grams of fat or less fat per ounce)
Ricotta2 oz
Mozzarella1 oz
Feta1 oz
Other
Egg (limit to 3 per week) 1
Tofu (2 1/2 inches x 2 3/4 inches x 1 inch)4 oz or 1/2 cup
Sausage with 5 grams or less fat/ounce1 oz
Soy milk1 cup
HIGH FAT MEAT
(One exchange diet has 7 grams of protein, 8 grams of fat, 100 calories
and is equal to any one of the following items.)
Pork
Spareribs1 oz
Pork, ground1 oz
Sausage1 oz
Cheese (regular)
American1 oz
Cheddar1 oz
Swiss1 oz
Monterey Jack1 oz
Other
Luncheon meat (with 8 grams or less fat per ounce) 1 oz
Bologna1 oz
Pimento loaf. 1 oz
Salami1 oz
Sausage, such as Polish, Italian1 oz
Frankfurter (turkey or chicken) 1
Bacon3 slices
Count as one high-fat meat exchange plus one fat exchange:
Frankfurter (beef or pork) 1
Peanut butter2 tbsp


VEGETABLE  LIST

Each vegetable on this list contains about 5 grams of carbohydrate, 2 grams of protein, 0 grams of fat and 25 calories.
Vegetables contain 2-3 grams of dietary fiber.
Unless stated otherwise, one vegetable exchange diet is 1/2 cup of cooked vegetable or 1/2 cup of vegetable juice or 1 cup of raw vegetables.

Artichoke1
Artichoke hearts1
Asparagus1
Beans (green, wax, Italian)1
Bean sprouts1
Beets1
Broccoli1
Brussels sprouts1
Cabbage1
Carrots1
Cauliflower1
Celery1
Cucumber1
Eggplant1
Greens (collard, kale, mustard, turnip) 1
Green onions1
Kohlrabi1
Leeks1
Mixed vegetables (without corn, peas, or pasta) 1
Mushrooms (cooked) 1
Okra1
Onions1
Pea pods1
Peppers (all varieties) 1
Radishes1
Salad greens1
Sauerkraut1
Spinach1
Summer squash1
Tomato1
Tomato sauce1
Tomato/vegetable juice1
Turnips1
Water chestnuts1
Watercress1
Zucchini1


FAT  LIST

Fats are divided into monounsaturated, polyunsaturated, and saturated fats.
Each serving on the fat exchange diet list contains 5 grams of fat and 45 calories.
Items on this list should be used sparingly.

MONOUNSATURATED  FATS
Avocado, medium1/8 (1 oz)
Oil (canola, olive, peanut) 1 tsp
Olives, ripe (black) 8 large
Olives, green, stuffed 10 large
Nuts, almonds, cashews6 nuts
Nuts, mixed (50% peanuts)6 nuts
Peanuts10 nuts
Pecans4 halves
Peanut butter, smooth or crunchy1 1/2 tsp
Sesame seeds1 tbsp
POLYUNSATURATED  FATS
Margarine, (stick, tub, squeeze)1 tsp
Margarine, reduced-fat 1 tbsp
Mayonnaise, regular1 tsp
Mayonnaise, reduced-fat1 tbsp
Miracle Whip, regular2 tsp
Miracle Whip, light1 tbsp
Oil (corn, safflower, soybean)1 tsp
Salad dressings, regular1 tbsp
Salad dressings, reduced-fat2 tbsp
Seeds, pumpkin or sunflower1 tbsp
SATURATED  FATS
Butter, stick1 tsp
Butter, whipped 2 tsp
Butter, reduced fat1 tbsp
Bacon1 slice
Chitterlings1/2 oz
Coconut, shredded2 tbsp
Cream, light or half and half2 tbsp
Cream, sour, regular2 tbsp
Cream, sour, reduced fat3 tbsp
Cream, heavy, whipping1 tbsp
Cream cheese, regular1 tbsp
Cream cheese, reduced fat2 tbsp
Salt pork1/4 oz
Shortening or lard1 tsp


FREE  FOODS  LIST

A free food is any food or drink that contains less than 20 calories or less than 5 grams of carbohydrate per serving.
Use as much as you want for those items in your exchange diet that have no serving size specified.
Items that have a specific serving size should be limited to 3 servings per day.

FAT-FREE OR REDUCED-FAT FOODS
Cream cheese, fat-free1 tbsp
Creamers, nondairy, liquid1 tbsp
Creamers, nondairy, powdered2 tsp
Mayonnaise, fat-free1 tbsp
Mayonnaise, reduced-fat1 tsp
Margarine, fat-free4 tbsp
Margarine, reduced-fat1 tsp
Non-stick cooking spray
Salad dressing, mayonnaise-type, fat free1 tbsp
Salad dressing, mayonnaise-type, reduced fat 1 tsp
Salad dressing, fat free1 tbsp
Salad dressing, fat-free, Italian2 tbsp
Salsa1/4 cup
Sour cream, fat free1 tbsp
Whipped topping2 tbsp
SUGAR-FREE OR LOW-SUGAR FOODS
Candy, hard, sugar-free1
Candy, Gelatin, sugar-free2 tsp
Gum, sugar-free2 tsp
Jam/jelly, sugar-free2 tsp
Pancake syrup, sugar-free2 tbsp
Sugar substitute
DRINKS
Bouillon or broth without fat Bouillon1 tbsp
Low-sodium Carbonated drinks1 tbsp
Sugar-free Club soda Cocoa powder, unsweetened1 tbsp
Coffee/tea Drink mixes, sugar-free
Tonic water, sugar-free
CONDIMENTS
Catsup1 tbsp
Horseradish Lemon1 1/2 large
Lime juice Mustard Pickles, unsweetened1 1/2 large
Soy sauce Taco sauce1 tbsp
Vinegar


COMBINATION  FOODS  LIST

Many foods we eat are combinations of foods that do not fit into only one exchange diet list.
This list gives average values for some typical combination foods and can help you fit these foods into your meal plan.

FOODAMOUMTEXCHANGE
Casseroles, homemade1 cup (8 oz)2 carbohydrates, 2 medium-fat meats
Cheese pizza, thin crust1/4 of 10"2 carbohydrates, 2 medium-fat meats
1 fat
Pizza, meat topping, thin crust1/4 of 10"2 carbohydrates, 2 medium-fat meats
2 fat
Macaroni and cheese, beans1 cup (8 oz) 2 carbohydrates, 2 medium-fat meats
Soups
Bean1 cup (8 oz) 1 carbohydrate, 1 very lean meat
Cream, made with water1 cup (8 oz) 1 carbohydrate, 1 fat
Split pea made with water1/2 cup (4 oz) 1 carbohydrate
Vegetable, beef, or chicken noodle1 cup (8 oz) 1 carbohydrate


For using this table properly and effectively you better ask and check with your dietitian or your diabetes educator.
You might find their advise and directions very useful, and you can produce from these lists a variety of flexible and different meals and meal plans.






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