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Diabetes: Exchange List

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KEY POINTS

  • The exchange list meal plan divides foods into starch, fruit, milk, vegetable, meat, and fat groups. The plan gives you serving sizes for foods in each group that have about the same amount of carbohydrate, protein, fat, and calories. This lets you or your child exchange, or swap, choices from a food list.
  • A dietitian will help you plan how much food your child should have at each meal and how to choose foods from the lists. The exchange meal plan is very flexible. It is also helpful if your child is overweight and needs to keep track of calories.

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What are the exchange lists?

The exchange list meal plan divides foods into starch, fruit, milk, vegetable, fat, and meat groups. The plan gives you serving sizes for foods in each group that have about the same amount of carbohydrate, protein, fat, and calories. This lets you or your child exchange, or swap, choices from a food list. The number of servings from each food group that your child should have is based on how many calories your child needs each day.

A dietitian will help you plan how much food your child should have at each meal and from which lists the foods should come from. The exchange meal plan is very flexible. It is also helpful if your child is overweight and needs to keep track of calories.

The following are groups of foods included on the exchange lists.

Starch

One starch exchange contains about 15 grams of carbohydrate, 0 to 3 grams of protein, 0 to 1 gram of fat, and 80 calories. A starch exchange is sometimes called a carb exchange and includes foods such as bread, cereals, rice, and starchy vegetables such as potatoes and corn.

Fruit

One fruit exchange contains about 15 grams of carbohydrate and 60 calories.

Milk

One milk exchange contains about 8 grams of protein and 12 grams of carbohydrate, 0 to 3 grams of fat, and 100 calories. A milk exchange includes milk and yogurt.

Vegetable

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.

Meat and Protein Sources

Meats are divided into very lean meats, lean meats, medium-fat meats, and high-fat meats. Try to eat more lean and medium-fat meats and stay away from high-fat meats. The leaner the meat, the fewer the calories and fat. All meat exchanges have 7 grams of protein in 1 meat exchange. Other protein foods that are considered a meat exchange include cottage cheese, eggs, and cheese.

Fat

Your body needs the right kind and the right amount of fat to work properly. One fat exchange contains 5 grams of fat and 45 calories. Monounsaturated fats and polyunsaturated fats are healthier than saturated fats. Examples include avocado, nuts, olive oil, canola oil, and corn oil.

Free Foods

A free food contains less than 20 calories and less than 5 grams of carbohydrate per serving. If the food has a serving size listed on its package, limit the amount you eat to 3 servings spread throughout the day. Some examples of free foods are light or sugar-free jelly, fat-free cream cheese, fat-free or low-fat salad dressing, salsa, and ketchup.

Combination Foods

Combination foods, such as casseroles, have foods from different food groups mixed together. Your dietitian can help you figure out how to count exchanges 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 carb exchanges and 2 medium-fat meat exchanges
  • Chicken noodle soup (1 cup) = 1 carb exchange
  • Frozen entrée (less than 300 calories) = 2 carb exchanges and 3 lean meat exchanges
  • Macaroni and cheese (1 cup) = 2 carb exchanges and 2 medium-fat meat exchanges

For books that help you with exchange food groups and other information to help manage diabetes, contact:

Developed by Change Healthcare.
Pediatric Advisor 2019.4 published by Change Healthcare.
Last modified: 2019-01-31
Last reviewed: 2019-01-22
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.
© 2018 Change Healthcare LLC and/or one of its subsidiaries
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