Exchange Diet for Diabetes

The exchange diet divides the foods to groups that contain roughly the same mix of carbohydrates, protein, fat, and calories.
There are six main groups:

• Bread
• Meat
• Vegetables
• Fruit
• Milk
• Fat

Below you can see the table with the list of each group.
Each list contains foods that are alike, i.e., each food choice on a list contains about the same amount of carbohydrate, protein, fat, and calories as the other choices on that list.
The basic unit is a serving which is well defined so that each food from its list will have the same amount of carbohydrate, fat, and protein as any other.
The amount of every food in the right column on the list is 1 serving which is the common denominator.
Now, what you have to do is to "exchange" foods or trade with other foods from the same list while still keeping nutrition values.
Each meal is composed of foods from the exchange lists of every group.
Notice, in the second table below, that the amount of servings of each group is well defined and final.
For changing these amounts, according to your calorie needs, your weight, height, age, and your activity, you should talk with your dietitian.
The exchange diet lists were designed in the first place for people with diabetes and others who have to keep special diets by the American Diabetes Association in cooperation with the American Dietetic Association.

The following chart shows the amounts of nutrients in one serving from each exchange diet list.

Group	Carbohydrate (gr.)	Protein (gr.)	Fat (gr.)	Calories
Bread/Starch	15	3	trace	80
Meat
Very Lean	-	7	0-1	35
Lean	-	7	3	55
Medium-Fat	-	7	5	75
High-Fat	-	7	8	100
Vegetables	5	2	-	25
Fruit	15	-	-	60
Milk
Skim	12	8	0-3	90
Low-Fat	12	8	5	120
Whole	12	8	8	150
Fat	-	-	5	45

The following chart shows the recommended combination of the exchange diet list of 1600 calories of food consumption for one day.

Group	Number of Servings Per 1 Day	Calories in 1 Serving	Total Calories
Bread/Starch	7	80	560
Meat (very lean)	7	35	245
Vegetables	6	25	150
Fruit	4	60	240
Milk (skim)	3	90	270
Fat	3	45	135
Total	30		1600

The amount of every food in the right column on the lists below is equal to 1 serving.

BREAD/STARCH   LIST

Each item in this list contains approximately 15 grams of carbohydrate, 3 grams of protein, and a trace of fat per serving.
Each item contains 80 calories.
The numbers on the right indicate the serving size for the exchange diet.

BREAD
Bagel	1/2 (1 oz)
Bread reduced-calorie	2 slices (1 1/2 oz)
Bread-white, wheat, rye	1 slice (1 oz)
Bread sticks, crisp 4 inches long,	1/2 inch thick, 2 (2/3 oz)
English muffin	1/2
Frankfurter or hamburger bun	1/2 (1 oz)
Pita, 6 inches across	1/2
Plain roll, small	1 (1 oz)
Raisin, unfrosted	1 slice (1 oz)
Tortilla, 6 inches across	1
STARCHY VEGETABLES
Corn	1/2 cup
Corn on the cob, 6-inch	1
Peas, green	1/2 cup
Potato, baked or boiled	1 small (3 oz)
Potato, mashed	1/2 cup
Squash, winter (acorn or butternut)	1 cup
Yam, sweet potato, plain	1/2 cup
Baked beans	1/3 cup
CEREALS, GRAINS, PASTA
Bran cereals	1/2 cup
Bulgur	1/2 cup
Cooked cereals	1/2 cup
Cornmeal, dry	3 tbsp
Grape-Nuts	1/4 cup
Grits, cooked	1/2 cup
Cereals, unsweetened	3/4 cup
Cereals, sugar-frosted	1/2 cup
Pasta, cooked	1/2 cup
Puffed cereal	1 1/2 cup
Rice, white or brown (cooked)	1/3 cup
Shredded wheat	1/2 cup
Wheat germ	3 tbsp
CRACKERS, SNACKS
Animal crackers	8
Graham crackers, 2 1/2 inches	3
Matzoth	3/4 oz
Melba toast	4 slices
Oyster crackers	24
Popcorn (popped, no fat added)	3 cups
Pretzels	3/4 oz
Rice Cakes, 4 inches across	2
Saltine-type crackers	6
Whole wheat crackers (no fat)	2-5 (3/4 oz)
STARCHY FOOD PREPARED WITH FAT
(Count as 1 starch/bread serving plus 1 fat serving)
Biscuit, 2 1/2 inches across	1
Chow-mein noodles	1/2 cup
Corn bread, 2 inch cube	1 (2 oz)
Cracker, round butter type	6
Croutons	1 cup
French fried potatoes	16-25 (3 oz)
Granola	1/4 cup
Muffin, plain, small	1
Pancake, 4 inches across	2
Stuffing, bread (prepared)	1/3 cup
Taco shell, 6 inches across	2
Waffle, 4 1/2 inches square	1
Whole wheat crackers (fat added)	4-6 (1 oz)
Popcorn, microwave	3 cups
Sandwich crackers, peanut butter	3

Exchange diet can be applied to most any eating situation and may make it easier to follow a prescribed diet.
For example, if a nutrition plan calls for one bread exchange a person could choose 1/2 cup of cooked pasta, OR one slice of bread, OR a small (3 oz.) baked potato.

MILK LIST

Each item in this exchange diet list contains approximately 12 grams of carbohydrate, 8 grams of protein, and the fats are divided into 3 main groups: skim and very low fat milk, low fat milk, and whole milk.

SKIM AND VERY LOW-FAT MILK
(One exchange contains 12 grams of carbohydrate, 8 grams of protein, 0-3 grams of fat and 90 calories.)
Skim milk	1 cup
1/2% milk	1 cup
1% milk	1 cup
Nonfat or low-fat buttermilk	1 cup
Evaporated skim milk	1/2 cup
Dry nonfat milk	1/3 cup
Plain nonfat yogurt	3/4 cup
low fat fruit-flavored yogurt with non-nutritive sweetener	1 cup
LOW-FAT MILK
(One exchange contains 12 grams of carbohydrate,8 grams of protein, 5 grams of fat and 120 calories.)
2% milk	1 cup
Plain low-fat yogurt	3/4 cup
WHOLE MILK
(One exchange contains 12 grams of carbohydrate,8 grams of protein, 8 grams of fat and 150 calories.)
Limit choices from the whole milk category as much as possible.
Whole milk	1 cup
Evaporated whole milk	1/2 cup
Goat’s milk	1 cup

FRUIT LIST

Each item on this exchange diet list contains about 15 grams of carbohydrate and 60 calories.
Fresh, frozen and dry fruits have about 2 grams of fiber per serving.
Fruit juices contain very little dietary fiber.
Use fresh fruits or fruits frozen or canned without added sugar.
Unless stated otherwise, the serving size for one fruit exchange diet may include 1/2 cup of fresh fruit or fruit juice or 1/4 cup of dried fruit.

FRESH FRUIT
Apple (raw, 2 inches across)	1 apple
Applesauce (unsweetened)	1/2 cup
Apricots (medium, raw)	4 apricots
Apricots (canned)	1/2 cup
Banana (small)	1 banana
Blackberries (raw)	3/4 cup
Blueberries (raw)	3/4 cup
Cantaloupe (5 inches across)	1/3 melon
Cantaloupe (cubes)	1 cup
Cherries (large, raw)	12 cherries
Cherries (canned)	1/2 cup
Figs (raw)	1 1/2 large or 2 medium
Fruit cocktail (canned)	1/2 cup
Grapefruit (large)	1/2 fruit
Grapefruit, segments	3/4 cup
Grapes (small)	17 grapes
Honeydew (medium)	1 slice (10 oz)
Honeydew (cubes)	1 cup
Kiwi (large)	1 fruit
Mandarin oranges	3/4 cup
Mango (small)	1/2 mango or 1/2 cup
Nectarine (small)	1 nectarine
Orange (small)	1 orange
Peach (medium)	1 peach 3/4 cup
Peaches (canned)	1/2 cup 2 halves
Pear	1/2 large
Pears (canned)	1/2 cup 2 halves
Pineapple (raw)	3/4 cup
Pineapple (canned)	1/2 cup
Plums (small)	2 plums
Raspberries (raw)	1 cup
Strawberries (raw, whole)	1 1/4 cup
Tangerine (small)	2 fruits
Watermelon, cubes	1 1/4 cup
DRIED FRUIT
Apples	4 rings
Apricots	8 halves
Dates	3 medium
Figs	1 1/2
Prunes	3 medium
Raisins	2 tbsp
FRUIT JUICES
Apple juice/cider	1/2 cup
Cranberry juice cocktail	1/3 cup
Cranberry juice cocktail, reduced-calorie	1 cup
Grapefruit juice	1/2 cup
Grape juice	1/3 cup
Orange juice	1/2 cup
Pineapple juice	1/2 cup
Prune juice	1/3 cup
Fruit juice blends, 100% juice	1/3 cup

MEAT  AND  MEAT  SUBSTITUTE  LIST

Each serving of meat and substitute on this exchange diet list contains about 7 grams of protein.
The amount of fat and calories varies, depending on the choice.
The list is divided into very lean meat, lean meat, medium-fat meat and high-fat meat.
One meat exchange diet can be one of the following: 1 ounce of meat, 1 ounce of poultry, 1 ounce of fish, 1 ounce of cheese, 1/2 cup of dried beans.

VERY LEAN MEAT
(One exchange diet has 7 grams of protein, 0-1 grams fat and 35 calories
and equals any one of the following items.)
Poultry
Chicken or turkey (white meat no skin)	1 oz
Cornish hen (no skin)	1 oz
Fish
Fresh or frozen cod	1 oz
Flounder	1 oz
Haddock	1 oz
Halibut	1 oz
Trout	1 oz
Tuna, fresh or canned in water	1 oz
Shellfish, imitation shellfish	1 oz
Clams, crab, lobster, scallops, shrimp	1 oz
Game
Duck or pheasant (no skin)	1 oz
Venison	1 oz
Buffalo	1 oz
Ostrich	1 oz
Cheese with 1 gram or less fat per ounce	1/4 cup
Nonfat or low-fat cottage cheese	1/4 cup
Fat-free cheese	1 oz
Meat sandwich with 1 gram or less fat per ounce	1 oz
Meat sandwich, deli thin	1 oz
Meat (shaved), chipped beef, turkey ham	1 oz
Egg whites	2
Egg substitutes, plain	1/4 cup
Hot dogs with 1 gram or less fat per ounce	1 oz
Kidney (high cholesterol)	1 oz
Sausage with 1 gram or less fat per ounce	1 oz
Count as one very lean meat and one starch exchange
Dried beans, peas, lentils (cooked)	1/2 cup
LEAN MEAT
(One exchange diet has 7 grams of protein, 3 grams of fat, 55 calories
and equals any one of the following items.)
Beef
USDA Select or Choice grades of trimmed lean round	1 oz
Sirloin and flank steak	1 oz
Tenderloin	1 oz
Roast (rib, chuck, rump)	1 oz
Steak (t-bone, porter house, cubed)	1 oz
Ground round	1 oz
Pork
Lean pork	1 oz
Fresh ham, canned, cured, or boiled ham	1 oz
Canadian bacon	1 oz
Tenderloin	1 oz
Center loin chop	1 oz
Lamb
Roast	1 oz
Chop	1 oz
Leg	1 oz
Veal
Lean chop	1 oz
Roast	1 oz
Poultry
Chicken (white meat with skin)	1 oz
Chicken (dark meat, no skin)	1 oz
Turkey (dark meat, no skin)	1 oz
Duck or goose, domestic (well drained of fat, no skin)1 oz
Fish
Oysters	6 medium
Tuna (canned in oil, drained)	1 oz
Herring	1 oz
Salmon (fresh or canned), catfish	1 oz
Sardines (canned)	2 medium
Wild Game
Goose (without skin), rabbit	1 oz
Cheese
Cottage cheese (4.5% fat)	1/4 cup
Grated parmesan	2 tbsp
Diet cheeses (3 grams fat or less)	1 oz
Other
Hotdogs with 3 grams or less fat/ounce	1 1/2 oz
Luncheon meat with 3 grams or less fat/ounce	1 oz
MEDIUM FAT MEAT
(One exchange diet has 7 grams of protein, 5 grams of fat, 75 calories
and equals any one of the following items.)
Beef(Most beef products fall into this category)
Beef, ground	1 oz
Meatloaf	1 oz
Corned beef	1 oz
Short ribs	1 oz
Prime grades of meat trimmed of fat, prime rib	1 oz
Pork
Chops	1 oz
Top loin	1 oz
Boston butt	1 oz
Cutlets	1 oz
Lamb
Rib	1 oz
Roast	1 oz
Ground	1 oz
Veal
Cutlet (unbreaded)	1 oz
Poultry
Chicken (dark meat with skin)	1 oz
Turkey, ground	1 oz
Chicken, ground	1 oz
Fried chicken (with skin)	1 oz
Fish Any fried fish product	1 oz
Cheese (With 5 grams of fat or less fat per ounce)
Ricotta	2 oz
Mozzarella	1 oz
Feta	1 oz
Other
Egg (limit to 3 per week)	1
Tofu (2 1/2 inches x 2 3/4 inches x 1 inch)	4 oz or 1/2 cup
Sausage with 5 grams or less fat/ounce	1 oz
Soy milk	1 cup
HIGH FAT MEAT
(One exchange diet has 7 grams of protein, 8 grams of fat, 100 calories
and is equal to any one of the following items.)
Pork
Spareribs	1 oz
Pork, ground	1 oz
Sausage	1 oz
Cheese (regular)
American	1 oz
Cheddar	1 oz
Swiss	1 oz
Monterey Jack	1 oz
Other
Luncheon meat (with 8 grams or less fat per ounce)	1 oz
Bologna	1 oz
Pimento loaf.	1 oz
Salami	1 oz
Sausage, such as Polish, Italian	1 oz
Frankfurter (turkey or chicken)	1
Bacon	3 slices
Count as one high-fat meat exchange plus one fat exchange:
Frankfurter (beef or pork)	1
Peanut butter	2 tbsp

VEGETABLE  LIST

Each vegetable on this list contains about 5 grams of carbohydrate, 2 grams of protein, 0 grams of fat and 25 calories.
Vegetables contain 2-3 grams of dietary fiber.
Unless stated otherwise, one vegetable exchange diet is 1/2 cup of cooked vegetable or 1/2 cup of vegetable juice or 1 cup of raw vegetables.

Artichoke	1
Artichoke hearts	1
Asparagus	1
Beans (green, wax, Italian)	1
Bean sprouts	1
Beets	1
Broccoli	1
Brussels sprouts	1
Cabbage	1
Carrots	1
Cauliflower	1
Celery	1
Cucumber	1
Eggplant	1
Greens (collard, kale, mustard, turnip)	1
Green onions	1
Kohlrabi	1
Leeks	1
Mixed vegetables (without corn, peas, or pasta)	1
Mushrooms (cooked)	1
Okra	1
Onions	1
Pea pods	1
Peppers (all varieties)	1
Radishes	1
Salad greens	1
Sauerkraut	1
Spinach	1
Summer squash	1
Tomato	1
Tomato sauce	1
Tomato/vegetable juice	1
Turnips	1
Water chestnuts	1
Watercress	1
Zucchini	1

FAT  LIST

Fats are divided into monounsaturated, polyunsaturated, and saturated fats.
Each serving on the fat exchange diet list contains 5 grams of fat and 45 calories.
Items on this list should be used sparingly.

MONOUNSATURATED  FATS
Avocado, medium	1/8 (1 oz)
Oil (canola, olive, peanut)	1 tsp
Olives, ripe (black)	8 large
Olives, green, stuffed	10 large
Nuts, almonds, cashews	6 nuts
Nuts, mixed (50% peanuts)	6 nuts
Peanuts	10 nuts
Pecans	4 halves
Peanut butter, smooth or crunchy	1 1/2 tsp
Sesame seeds	1 tbsp
POLYUNSATURATED  FATS
Margarine, (stick, tub, squeeze)	1 tsp
Margarine, reduced-fat	1 tbsp
Mayonnaise, regular	1 tsp
Mayonnaise, reduced-fat	1 tbsp
Miracle Whip, regular	2 tsp
Miracle Whip, light	1 tbsp
Oil (corn, safflower, soybean)	1 tsp
Salad dressings, regular	1 tbsp
Salad dressings, reduced-fat	2 tbsp
Seeds, pumpkin or sunflower	1 tbsp
SATURATED  FATS
Butter, stick	1 tsp
Butter, whipped	2 tsp
Butter, reduced fat	1 tbsp
Bacon	1 slice
Chitterlings	1/2 oz
Coconut, shredded	2 tbsp
Cream, light or half and half	2 tbsp
Cream, sour, regular	2 tbsp
Cream, sour, reduced fat	3 tbsp
Cream, heavy, whipping	1 tbsp
Cream cheese, regular	1 tbsp
Cream cheese, reduced fat	2 tbsp
Salt pork	1/4 oz
Shortening or lard	1 tsp

FREE  FOODS  LIST

A free food is any food or drink that contains less than 20 calories or less than 5 grams of carbohydrate per serving.
Use as much as you want for those items in your exchange diet that have no serving size specified.
Items that have a specific serving size should be limited to 3 servings per day.

FAT-FREE OR REDUCED-FAT FOODS
Cream cheese, fat-free	1 tbsp
Creamers, nondairy, liquid	1 tbsp
Creamers, nondairy, powdered	2 tsp
Mayonnaise, fat-free	1 tbsp
Mayonnaise, reduced-fat	1 tsp
Margarine, fat-free	4 tbsp
Margarine, reduced-fat	1 tsp
Non-stick cooking spray
Salad dressing, mayonnaise-type, fat free	1 tbsp
Salad dressing, mayonnaise-type, reduced fat	1 tsp
Salad dressing, fat free	1 tbsp
Salad dressing, fat-free, Italian	2 tbsp
Salsa	1/4 cup
Sour cream, fat free	1 tbsp
Whipped topping	2 tbsp
SUGAR-FREE OR LOW-SUGAR FOODS
Candy, hard, sugar-free	1
Candy, Gelatin, sugar-free	2 tsp
Gum, sugar-free	2 tsp
Jam/jelly, sugar-free	2 tsp
Pancake syrup, sugar-free	2 tbsp
Sugar substitute
DRINKS
Bouillon or broth without fat Bouillon	1 tbsp
Low-sodium Carbonated drinks	1 tbsp
Sugar-free Club soda Cocoa powder, unsweetened	1 tbsp
Coffee/tea Drink mixes, sugar-free
Tonic water, sugar-free
CONDIMENTS
Catsup	1 tbsp
Horseradish Lemon	1 1/2 large
Lime juice Mustard Pickles, unsweetened	1 1/2 large
Soy sauce Taco sauce	1 tbsp
Vinegar

COMBINATION  FOODS  LIST

Many foods we eat are combinations of foods that do not fit into only one exchange diet list.
This list gives average values for some typical combination foods and can help you fit these foods into your meal plan.

FOOD	AMOUMT	EXCHANGE
Casseroles, homemade	1 cup (8 oz)	2 carbohydrates, 2 medium-fat meats
Cheese pizza, thin crust	1/4 of 10"	2 carbohydrates, 2 medium-fat meats 1 fat
Pizza, meat topping, thin crust	1/4 of 10"	2 carbohydrates, 2 medium-fat meats 2 fat
Macaroni and cheese, beans	1 cup (8 oz)	2 carbohydrates, 2 medium-fat meats
Soups
Bean	1 cup (8 oz)	1 carbohydrate, 1 very lean meat
Cream, made with water	1 cup (8 oz)	1 carbohydrate, 1 fat
Split pea made with water	1/2 cup (4 oz)	1 carbohydrate
Vegetable, beef, or chicken noodle	1 cup (8 oz)	1 carbohydrate

For using this table properly and effectively you better ask and check with your dietitian or your diabetes educator.
You might find their advise and directions very useful, and you can produce from these lists a variety of flexible and different meals and meal plans.

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