The Diabetes Exchange Diet was developed by the American Dietetic Association in conjunction with the American Diabetes Association. It's designed to help people with diabetes consume the proper balance of carbohydrates, protein and fat to stabilize glucose levels. All foods are divided into seven different categories; you can exchange any food for another within the same category, but you can't switch between categories. The number of servings, called exchanges, that you eat from every group depends on your daily caloric intake.
Exchange Categories
There are seven exchange categories: starches, protein, vegetables, fruit, milk, fats and a "free" category. "Free" foods contain less than 20 calories per serving and include low-fat condiments, such as mustard, vinegar, soy sauce and salsa. Starches include starchy vegetables, as well as breads and pastas. Cheese is part of the protein group, not the milk category -- which includes milk, yogurt and milk substitutes such as almond or soy milk for people who are lactose intolerant. You should consume foods that don't fit into any category, such as sweets and desserts, sparingly; you can substitute them for foods in other categories, usually a combination of milk, fat and starch exchanges.
Exchange Guidelines
Each category has its own serving size/exchange based on a combination of calories, carbohydrate, fat, or protein content. Starch, fruit and milk exchanges all contain about 15 g of carbs; however, a fruit exchange should be about 60 calories, a starch exchange should be about 80 calories and contain 3 g of protein and a milk exchange should have 100 calories, 8 g of protein and 5 g of fat. A protein exchange contains 7 g of protein, 5 g of fat and 75 calories. A vegetable exchange is only 25 calories, should contain 5 g of carbs and 2 g of protein.
Daily Caloric Intake and Exchanges
The number of exchanges you eat in a day is determined by your specific nutrient needs. If you're on a 1,200 low-calorie diet, The University of Maryland Medical Center recommends you consume five starch, four protein, three fruit, three milk, two vegetable and two fat exchanges daily. If you're following an 1,800 calorie diet, you can consume 10 starch, seven protein, three vegetable, three fruit, three fat and two milk exchanges. On the high-end of the caloric spectrum, if you need 2,200 calories daily, you'll eat 13 starch, eight protein, five fat, four vegetable, three fruit and two milk exchanges.
Using the Diabetic Exchange System
The diabetic exchange system has a little bit of a learning curve, but once you learn what foods are in each category, you'll be able to design a menu that includes some of your favorite food choices. Many foods count as multiple exchanges or a combination of categories. Often, frozen meals designed for weight loss provide exchange information directly on the package. If not, reading labels will help you determine how many servings to eat. Portion control is important -- pay attention to serving size when dining out or using prepared foods.
