Medical nutrition therapy, or MNT, is an important part of diabetes treatment. Following a diabetic eating program will help you control glucose levels and maintain a healthy body weight, reducing your risk of developing health problems associated with obesity and diabetes. Problems include cardiovascular disease, kidney failure and nerve damage. Chronic hyperglycemia, or high glucose levels, can weaken blood vessels, causing them to rupture and stop supplying your organs and tissues with vital oxygen and nutrients. Follow your diabetes diet to avoid both high and low glucose levels.
The Diabetic Exchange Diet
Developed jointly by the American Diabetes Association and the American Dietetic Association, the exchange diet is flexible and user-friendly. It can help you control your carbohydrate intake and stabilize your blood sugar. All foods are divided into seven categories: starches, protein, vegetables, fruit, fat, milk, and a "free" category for foods under 20 calories per serving. Depending on your caloric needs, you're allowed a set number of exchanges from each category. The exchange plan is flexible. You can exchange one food for any other within the same category; you cannot exchange or substitute food between categories.
Food Categories
Exchanges are based on carbohydrate, protein, fat and calorie content. Each category has it's own nutritional requirements for an exchange. For example, a starch exchange is 80 calories, 15 g of carbohydrate and 3 g of protein. A fruit exchange is 60 calories and 15 g of carbohydrate, and a vegetable exchange is 25 calories and 5 g of carbohydrate. Exchanges are based on common serving sizes; you don't need to remember the requirements for each category, you can simply remember that a medium-sized apple, orange or peach is a fruit exchange -- so is a kiwi, 1/2 a large banana or 1/4 cup of any dried fruit. You can exchange one fruit for any other, allowing you to eat your favorite foods.
Exchanges and Calories
You don't need to count calories on the exchange program, although you do have to monitor portion sizes. If you follow a 1,500-calorie diet, each day, you can have eight starch exchanges, five protein, three exchanges each of vegetables, fruit and fat, and two milk exchanges. If you're very active, or just have a larger body type, and need 2,000 calories per day, you can have 11 starch exchanges, eight protein, four vegetable, four fat, three fruit and two milk. Don't confuse exchanges for servings -- a meat exchange is typically 1-oz. of cooked meat, so your 3-oz. hamburger may be one serving, but is equivalent to three protein exchanges.
Carbohydrate Counting
Although the exchange system is easy to use once you understand how foods are categorized and what the exchange sizes are, it can seem complicated in the beginning. If you'd like a simpler version, try counting carbohydrates. Carbohydrates have a more immediate impact on glucose than fat or protein. The American Diabetes Association recommends limiting carbohydrate intake to between 45 and 60 g per meal. Don't eat carbs by themselves -- always with lean protein and a healthy fat to slow digestion. Try to choose high-fiber carbohydrates that are nutrient-dense, avoiding refined sugars and flours, which will quickly raise your blood sugar.
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