The goal of the diabetic exchange diet is to provide an easy-to-follow, flexible eating plan that will help you control your blood sugar levels. Carbohydrates raise blood sugar levels; fiber fat and protein slow digestion and help minimize spikes in glucose. Although you may think only starchy foods, such as bread, potatoes, pasta and rice are carbohydrates, fruits, vegetables and dairy products also contain natural sugars that affect glucose levels. The diabetic exchange system takes these natural sugars into account by controlling portion sizes of all food groups, not just foods traditionally classified as carbs.
Exchange System Basics
Foods are divided into seven categories: starches, proteins, vegetables, fruits, fats, milk and "free" foods that are low in fat and contain less than 20 calories per serving. Condiments, such as mustard, vinegar and salsa are free foods, but mayonnaise and ketchup, with their high calories, fat and sugar content, are not. You are allowed to eat a certain number of servings -- called "exchanges" from each category. The reason a serving is called an exchange is because you can switch one food for another within any category. This allows you to eat your favorite foods, rather than being assigned a specific food to eat. You can only make exchanges within the same category -- you cannot substitute a milk food for a vegetable.
Category Requirements
Each category's exchange unit is based on the number of calories and grams of carbs, fat or protein. Exchanges from the carb group are 80 calories, 15 g of carbs and 3 g of protein. Protein exchanges are 75 calories, 7 g of protein and 5 g of fat. Vegetable exchanges are 25 calories, 5 g of carb and 2 g of protein. Fruit exchanges are 60 calories and 15 g of carbs. Fat exchanges are 45 calories and 5 g of fat. Milk exchanges are 120 calories, 15 g of carbs, 8 g of protein and 5 g of fat.
Using the Diabetic Exchange Diet
The number of exchanges you can eat from each group depends on your nutritional needs and energy requirements. You can work with a dietitian or follow the University of Maryland Medical Center guidelines, which suggest that if you're following a 1,500-calorie diet you eat the following exchanges: eight starch, five protein, three vegetable, three fruit, three fat and two milk. If you need more calories, a 2,000-calorie diet would use these exchanges: 11 starch, eight protein, four vegetable, four fat, three fruit and two milk. Milk is often limited because of its affect on glucose levels, but cheese is considered a protein -- only milk and yogurt are part of the milk group.
Examples of What to Eat
These exchanges are formulated to be easy to use -- you don't have to remember that a starch exchange is 15 g carbs, 3 g protein and 80 calories -- you only need to remember that a slice of bread, 1/2 cup of oatmeal, 1/2 cup of pasta, 1/2 cup of mashed potatoes or one-half of an English muffin or hamburger bun is one starch exchange. A whole English muffin is two exchanges. An apple, a kiwi or a small banana is one fruit exchange. A vegetable exchange is usually 1 cup of raw or 1/2 cup of cooked vegetables. The system helps teach you portion control and allows you the flexibility to dine out or cook at home.
