The diabetic exchange diet was developed in 1950 as a flexible nutritional program to help diabetics stabilize glucose levels. Designed by the American Dietetic Association, the U.S. Department of Public Health and the American Diabetes Association, the program was updated in 2008 to make it more "consumer friendly" and include exchanges for ethnic foods. The basic concept and food categories remain unchanged.
Diabetic Exchange Diet Basics
Foods are divided into six categories: starches, proteins, vegetables, fruits, fats and milk. Each category has its own exchange criteria -- a combination of calories, carbohydrates, fat, protein and fiber. Because the goal of the diet is stabilizing blood sugar, close attention is paid to carbohydrate counts. It's called an exchange system because you can exchange any food for another within the same category. You can't substitute foods from one category to another; but this system offers more flexibility than many other diabetic diets. Don't confuse exchange and serving size. For example, a typical serving of protein is 3 oz., but an exchange is typically 1 oz. of cooked protein -- so a 3-oz. hamburger is one serving, but three exchanges.
Food Category Requirements
Once you understand the nutrient requirements for an exchange in each category, you'll be able to calculate the exchange value of any packaged food by its nutrition label. A starch exchange contains 80 calories, 15 g of carbs and 3 g of protein; a protein exchange contains 75 calories, 7 g of protein and no more than 7 g of fat; a vegetable exchange has 25 calories, 5 g of carbs, 2 g of protein and at least 2 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; and a milk exchange has 120 calories, 15 g of carbs, 8 g of protein and 5 g of fat.
Exchanges for a 1,500 Calorie Diet
The number of exchanges you'll eat from each category depends on your daily calories. If you're following a 1,500-calorie diet, you should eat the following exchanges: eight starch, five meat, three vegetable, three fruit, three fat and two milk. If you increase your calorie intake, you'll add more exchanges from each category, except from milk or fruit, according to the University of Maryland Medical Center. Milk has an immediate impact on glucose levels and is limited to two exchanges, regardless of caloric intake. Fruit, although nutrient-dense and an important part of any diet often contains high amounts of natural sugars.
Other Tips
To keep glucose levels stable, space your meals and snacks evenly throughout the day. Don't eat starches or high-carbohydrate foods, such as fruit or milk, by themselves -- always eat carbs with protein or fat, which slow the conversion of food into glucose. Following the exchange diet is only part of your diabetes management. You'll also need to follow a regular exercise program and take any diabetes medication on schedule. Monitor your glucose levels carefully -- chronic hypoglycemia or hyperglycemia may indicate that your diabetes treatment plan needs to be adjusted.
References
- University of Maryland Medical Center; Diabetes Diet -- Diabetic Exchange Lists; May 2009
- "Diabetes Spectrum"; Choose Your Foods: Exchange Lists for Diabetes: The 2008 Revision of Exchange Lists for Meal Planning; Patti Bazel Geil; October 2008
- MayoClinic.com; Your Diabetes Diet: Exchange Lists; May 2010
