Overview
Exchange lists help with meal planning for diabetes management and weight loss. An exchange defines a group of interchangeable foods with approximately the same nutritional value in terms of calories, carbohydrate, protein and fat. An individualized meal plan indicates how many carbohydrate choices (starch, fruit and milk servings) to include at each meal or snack and the person with diabetes decides which foods to eat.
Step 1
Consult a registered dietitian or certified diabetes educator to prepare an individualized meal plan. Obtain a copy of the diabetes exchange lists, such as the lists provided by the Mayo Clinic or the lists published jointly by the American Dietetic Association and American Diabetes Association. The individualized meal plan developed together should meet health needs and be adjustable to accommodate changing needs such as work schedule, vacation or travel. The exchange lists help with food selections for the meal plan.
Step 2
Compare the meal plan with the lifestyle of the individual with diabetes to ensure that the pattern of eating improves glycemic control and does not disrupt daily living. Learn about the individual’s daily routine including time of waking, work schedule, meal times, type and timing of exercise and sleep habits. Food aversions or allergies, frequency of eating out, who prepares meals, eating or digestion problems, medications and their timing and any supplement usage must fit into the meal plan.
Step 3
Get familiar with each exchange list. Note that foods of similar nutrient content and serving size are grouped together. “Choose Your Foods: Exchange Lists for Diabetes” includes separate lists for starch, fruits, milk, sweets, nonstarchy vegetables, meat, fats, free foods, combination foods, fast foods and alcohol.
Step 4
Scan the lists of starches, fruits, milk products, sweets, meats and fats. Foods on the lists of starches, fruits and sweets each provide 15 g of carbohydrate. Starches include breads, cereals and grains, starchy vegetables, crackers, snacks, beans, peas and lentils. Milk choices such as fat-free, low-fat, 1 percent reduced fat, 2 percent, whole milk or yogurt each provide 12 g of carbohydrate. Nonstarchy vegetables contain 5 g of carbohydrate. Plant-based proteins and alcohol provide a variable amount of carbohydrate. Meats do not count toward total carbohydrate consumption.
Step 5
Learn serving sizes. Each food on an exchange list has a designated serving size to make it comparable in nutrient value to other foods on the same list. For instance, each serving size of bread, cereal or grain choice on the starch list contains 15 g of carbohydrate. So one biscuit, ½ an English muffin, one 6-inch corn tortilla or one 4-inch-square waffle each counts as one carbohydrate choice.
Step 6
Select food choices from the exchange lists to complete the number of carbohydrate choices for each meal and snack in the meal plan. Food, especially carbohydrate, turns into glucose, so the meal plan limits the number of carbohydrate choices and spreads them evenly throughout the day to avoid spikes and dips in glucose levels.
Step 7
Practice counting “carbs” or carbohydrate choices at each meal whether planned in advance or selected from a restaurant or fast food menu. With practice, the exchange lists, carb choices and serving sizes become second nature.
Tips and Warnings
- A “free” food has less than 20 calories and 5 g or less of carbohydrate per serving. It does not count as a carbohydrate choice, but limit free foods to three servings per day.
- Some individuals may require additional training sessions and practice to use the exchange lists effectively.
About this Author
Norma DeVault, a registered dietitian, has been writing health-related articles since 2006. Her articles have appeared in the “Journal of the American Dietetic Association.” She holds a Doctor of Philosophy in human environmental sciences from Oklahoma State University and a Master of Business Administration from the University of Tulsa.
