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Diabetes: Exchange List

What are the exchange lists?

The exchange lists show you portions of food that equal 1 exchange. Foods are divided into food lists. The foods on each list are called exchanges because they have a similar number of calories, protein, carbohydrate, and fat content. Foods from each list can be traded or "exchanged" for any other food on the same list because they all have a similar exchange value. A dietitian will help you plan how much food your child should eat at each meal and from what lists the foods should come from.

At first you should measure your food until you are able to make good estimates about serving sizes. The following list is a sample of foods found on the exchange lists.

Carbohydrate group

Starch List: One starch exchange contains about 15 grams of carbohydrate, 3 grams of protein, 0 to 1 grams of fat, and 80 calories. A starch exchange is sometimes called a carb exchange.

Fruit List: 1 fruit exchange contains about 15 grams of carbohydrate and 60 calories.

Milk List: 1 milk exchange contains about 8 grams of protein and 12 grams of carbohydrate.

Vegetable List: One vegetable exchange has 5 grams of carbohydrate, 2 grams of protein, no fat, and 25 calories. One-half cup of cooked or a cup of raw vegetables is a good measure for 1 exchange of most vegetables. Raw lettuce may be taken in larger quantities, but salad dressing usually equals 1 fat exchange.

Meat and Meat Substitute Group

Meats are divided into very lean meats, lean meats, medium-fat meats, and high-fat meats. People with diabetes should try to eat more lean and medium fat meats and stay away from the high fat choices.

The Very Lean meat group includes foods that contain 7 grams of protein, 0 to 1 gram of fat, and 35 calories for 1 exchange.

The Lean meat group includes foods that contain 7 grams of protein, 3 grams of fat, and 55 calories for 1 meat exchange.

Medium-Fat foods have 7 grams of protein, 5 grams of fat, and 75 calories for 1 meat exchange.

High-Fat foods have 7 grams of protein, 8 grams of fat, and 100 calories for 1 meat exchange.

Fat Group

Fat List: Fat is necessary for the body and is particularly important during periods of fasting (overnight), when it is very slowly absorbed. 1 fat exchange contains 5 grams of fat and 45 calories. The monounsaturated fats and polyunsaturated fats are better for us than saturated fats.

Free Foods

A free food contains less than 20 calories or less than 5 grams of carbohydrate per serving. If the food has a serving size listed on its package, it should be limited to 3 servings spread throughout the day.

Combination Foods

Many foods, such as casseroles, are mixed together. Your dietitian can help you figure out how many exchanges to count for combination foods. For example:

  • Lasagna (1 cup) = 2 carb exchanges and 2 medium-fat meat exchanges
  • Spaghetti with meatballs (1 cup) = 2 carb exchanges and 2 medium-fat meat exchanges
  • Pizza, cheese (1/4 of 12 in.) = 2 carbs, 2 medium-fat meats
  • Chicken noodle soup (1 cup) = 1 carb exchange
  • Frozen entrée (less than 300 calories) = 2 carbs, 3 lean meat exchanges
  • Macaroni and cheese (1 cup) = 2 carb exchanges and 2 medium-fat meat exchanges

For more information, you can buy the Exchange Lists for Meal Planning from:

Developed by RelayHealth.
Pediatric Advisor 2013.2 published by RelayHealth.
Last modified: 2012-06-25
Last reviewed: 2012-06-18
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
© 2013 RelayHealth and/or its affiliates. All rights reserved.
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