The Diabetic Food Exchange is a meal program designed to help stabilize blood sugar. By limiting carbohydrates and including fiber, essential nutrients, lean protein and unsaturated fats, the exchange plan can help diabetics prevent the serious health complications associated with high blood sugar levels, such as nerve damage, kidney failure and blindness. Foods are divided into six categories and you're allowed a set number of servings, called exchanges, from each category. The number of exchanges you'll eat depends on your total daily caloric intake. You can exchange one food for another within a category, but you can't substitute foods from one category to a different category.
The Six Categories
The six food categories are starch, protein, vegetables, fruits, fats and milks. There is a "free" category for foods that are less than 20 calories and 5 g of carbohydrates per serving, such as low-fat condiments, sugar-free beverages, gum and sugar-free gelatin. You'll still have to limit servings of free foods -- calories can still add up. Cheese is part of the protein group, not the milk category, which includes milk, yogurt and ice cream.
Calories, Carbs, Protein, Fat and Fiber
Each category has it's own requirements for an exchange portion. A starch exchange is 80 calories, 15 g of carbs and 3 g of protein. A protein exchange is 75 calories, 7 g of protein and no more than 5 g of fat. A vegetable exchange has 25 calories, 5 g of carbs, 2 g of protein and 2 to 3 g of fiber. A fruit exchange has 60 calories and 15 g of carbs. A fat exchange has 45 calories and 5 g of fat. A milk exchange is 120 calories, 15 g of carbs, 8 g of protein and 5 g of fat.
Common Servings
Although learning the exact nutritional requirements for each food category is helpful, it's not necessary to follow the program. The exchange plan is designed to be user-friendly and most serving sizes work as an exchange. For example, one slice of whole grain bread, a 1/2 cup of oatmeal, 1/2 of a hamburger bun or English muffin or a 1/2 cup of pasta is a starch exchange. One cup of milk is a milk exchange. One oz. of most meats is a protein exchange; you simply consume multiple exchanges to equal a portion. For example, a 4-oz. hamburger on a regular bun would be four protein exchanges and two starch exchanges. Most condiments are "free foods."
Determining the Number of Exchanges to Eat
The number of exchanges you eat from each food category depends on how many calories you need. If you're trying to lose weight, following a 1,500 calorie diet would include eight starch, five meat, three vegetable, three, fruit, three fat and two milk exchanges. If you're very active, you may need 2,000 calories every day. The University of Maryland Medical Center recommends that a 2,000-calorie diet include 11 starch, eight meat, four vegetable, three fruit, four fat and two milk exchanges. Milk is limited to two exchanges in low and high calorie meal plans because it can have a dramatic impact on blood sugar.
