The American Diabetic Association promotes healthy eating and weight loss through a diet program that was once called the "Exchange List for Meal Planning," but was renamed "Choose Your Foods: Exchange Lists for Diabetes" in 2008. The exchange program is a flexible diet that allows diabetics to include some of their favorite foods, while limiting both calories and carbohydrates, which have a big impact on blood sugar.
Understanding The Exchange Program
The "Choose Your Food" diet divides foods into eight categories; previously there were seven categories, but an additional "sweets, desserts and other carbohydrates" category was added to include foods such as meal replacement bars and shakes, frozen yogurt and sports drinks. The eight categories are: starch, fruits, dairy, nonstarchy vegetables, meats, fat, sweets/desserts and free foods. Free foods are things such as condiments that contain less than 20 calories per serving. Portions are called exchanges because you can exchange one food for any other within the same category. You cannot substitute foods from one category for foods in another.
A 1,500-Calorie Plan
The number of exchanges you'll eat from each category depends on your caloric needs.Following a 1,500-calorie diet, you would eat eight starches, three fruits, two dairy, three vegetables, five meats and three fats. Sweets/desserts are considered part of the starch exchanges -- you can divide your eight exchanges between traditional starches and the newer sweets/category, but you still need to make nutrient-dense choices. You may want to work with a dietitian when beginning this diet to make sure you understand how to categorize foods and what an exchange is. Exchanges are often different from servings. For example, 1 oz. of most meats is an exchange; a 4-oz. hamburger may be one serving, but it's four meat exchanges.
Exchanges
Each category has a specific set of nutritional requirements for an exchange size, based on a combination of calories, carbohydrates, fat, fiber and protein. A starch exchange should be 80 calories, 15 g of carbohydrates and 3 g of protein, while a nonstarchy vegetable exchange contains about 25 calories, 5 g of carbs, 3 g of protein and between 2 g and 3 g of fiber. Learning the requirements for each category will allow you to determine the exchange value for a serving of any packaged food by reading the nutritional facts. Some packaged foods have exchange information already printed on the label.
Other Tips
Keep a food journal to track the number of exchanges you eat per meal and your daily total. Space your meals and snacks evenly throughout the day to help regulate your blood sugar level. Don't skip meals, and try to eat at least every four hours. Check your glucose level as directed by your doctor, and note any episodes of high or low blood sugar. Continue to take any diabetes medications as directed.
References
- "Diabetes Spectrum"; Choose Your Foods: Exchange Lists for Diabetes: The 2008 Revision of Exchange Lists for Meal Planning; Patti Bazel Geil
- University of Maryland Medical Center: Diabetes Diet -- Diabetic Exchange List
- National Institute of Diabetes and Digestive and Kidney Diseases: What I Need to Know About Eating and Diabetes
- American Diabetes Association: Making Healthy Food Choices
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