The exchange diet is designed to limit both calories and carbohydrates, helping diabetics maintain healthy weights and regulate glucose. Controlling blood sugar is a critical part of managing diabetes and avoiding serious health complications such as blindness, nerve damage and kidney disease. The exchange diet is flexible, allowing you to include your favorite foods while practicing portion control and ensuring proper nutrition.
Understanding the Exchange System
The diabetic exchange diet separates foods into six categories: starches, meats, vegetables, fruits, fats and dairy. Depending on your caloric needs, you consume a set number of exchanges or servings from each category. They're called exchanges because you can exchange any food for any other within the same category -- but you cannot exchange from one category to another. An exchange portion is based on a combination of calories, carbohydrates, fat, protein and fiber; each category has its own specific set of nutritional requirements.
Breakfasts
The number of exchanges you eat depends on your caloric intake, but you don't want to skip meals and should always have breakfast. Blood sugar levels are lowest after fasting overnight and food brings up glucose levels and jump-starts your metabolism. For breakfast, have a high-fiber starch, such as oatmeal or whole grain cereal, with protein and healthy fat. A 1/2 cup serving of cooked cereal is one starch exchange. You may use one of your dairy exchanges for low-fat yogurt or cottage cheese, which you can have with a piece of fruit. An exchange portion is not the same as a serving -- a 4-oz. bagel is four starch exchanges and an English muffin is two exchanges.
Lunches
To stabilize glucose levels, eat on a regular schedule and try to eat the same amount of food at each meal. What you eat, as well as how much you eat, matters. Aim to divide your food evenly throughout the day; eating too much at any one meal will spike your blood sugar level. Lunch should include complex carbs, lean protein and healthy fat. Try a turkey, chicken or tuna sandwich on whole grain bread with an apple or other piece of fruit. Start lunch with a cup of vegetable soup or a small green salad. You could also have a large salad with legumes, cheese or hard-boiled eggs. Choose a salad dressing without added sugars.
Dinners
If dinner is more than four hours after lunch, eating an afternoon snack will help keep glucose levels stable. You may also need another snack before bedtime to avoid nighttime hypoglycemia -- or low blood sugar. You could try poached fish with steamed vegetables and a small baked sweet potato, or whole wheat pasta primavera with grilled chicken breast. You could use the American Diabetes Association "create a plate" as a guide: fill one-half of your plate with non-starchy vegetables, one-quarter with lean protein and the last quarter with a high-fiber carbohydrate such as brown rice, millet or quinoa.
