The diabetes exchange list was created to make meal planning for people with diabetes easier. This is especially useful for those who are on insulin, as the amount of carbohydrate they consume determines how much insulin is needed to cover a meal. The food exchange system divides all foods into six groups: starch, fruit, milk, vegetable, meat and fat. A defined serving or "exchange" of each food item within a specific category has about the same amount of carbohydrates, protein, fat and calories. For example, foods on the starch list contain 15g of carbohydrates, zero to 3g of protein, zero to 1g of fat and 80 calories.
Starch
The starch list includes foods like cereals, grains, pasta, breads, crackers, starchy vegetables and legumes. In general, one exchange of starch is ½ cup of cooked cereal, grain, starchy vegetable, cooked rice or pasta. It is also equivalent to 1 oz. of bread product (1 slice of bread) or ¾ to 1 oz. of most snack foods (chips and crackers). Try to avoid starches with added fats, like croissants, chips and granola. Look for starchy foods with at least 3g of fiber per serving.
Fruits
The fruit list includes all fresh, frozen, canned, dried fruits and fruit juices. In general, 1 small fruit (about 4 oz.), ½ cup of canned, fresh fruit or unsweetened fruit juice, or 2 tbsp. of dried fruit are all considered one exchange of fruits. Each exchange is 15g of carbohydrates, 0g of protein and fat, and 60 calories. It is preferable to choose fresh fruit over fruit juice, as fresh fruit contain fiber.
Milk
All kinds of milk, yogurt and dairy-like foods (rice and soy milk) are included in this list. One milk exchange is equivalent to 8 oz. of milk regardless of the fat content, and each exchange is 12g of carbohydrates and 8g of protein. In order to avoid extra calories, choose lower-fat varieties such as non-fat or 1 percent milk or yogurts.
Nonstarchy Vegetables
Vegetables with small amounts of carbohydrates and calories are on the nonstarchy vegetables list. In general, one nonstarchy vegetable exchange is ½ cup of cooked vegetable or vegetable juice, or 1 cup of raw vegetables. Each exchange is only 5g of carbohydrates. So unless you eat 3 cups of more of raw vegetables or 1 ½ cups of cooked vegetables in a meal, you don't need to count the carbohydrates. Some examples of nonstarchy vegetables include broccoli, kale, spinach, kale, cabbage and summer squash.
Meat and Meat Substitutes
This list consists of foods that are high in protein and does not contain any carbohydrates. The amount of fat depends on the choice of meat or meat substitute. One exchange is equivalent to 1 oz. of meat which provides 7g of protein. If the meat or fish is breaded, then 3 tbsp. of flour, cornmeal or bread crumbs count as 15g of carbohydrates.
Fat
Fat is another list that does not contain any carbohydrates. Each fat exchange is equivalent to 1 tsp. of margarine, butter or oil. Even though fat does not contain carbohydrates, all fats are high in calories, which will contribute to weight gain. Gaining weight may worsen diabetes control.
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