Uncategorized
The Diabetic Exchange List (Exchange Diet)
*The Exchange Lists are the basis of a meal planning system designed by a committee of the American Diabetes Association and the American Dietetic Association. While designed primarily for people with diabetes and others who must follow special diets, the Exchange Lists are based on principles of good nutrition that apply to everyone.
The Exchange Lists
The reason for dividing food into six different groups is that foods vary in their carbohydrate, protein, fat, and calorie content. Each exchange list contains foods that are alike; 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 following chart shows the amounts of nutrients in one serving from each exchange list. As you read the exchange lists, you will notice that one choice is often a larger amount of food than another choice from the same list. Because foods are so different, each food is measured or weighed so that the amounts of carbohydrate, protein, fat, and calories are the same in each choice.
|
Carbohydrate |
Protein |
Fat |
Calories |
|
|
I. Starch/Bread |
15 |
3 |
trace |
80 |
|
II. Meat |
||||
|
Very Lean |
. |
7 |
0-1 |
35 |
|
Lean |
. |
7 |
3 |
55 |
|
Medium-Fat |
. |
7 |
5 |
75 |
|
High-Fat |
. |
7 |
8 |
100 |
|
III. Vegetable |
5 |
2 |
. |
25 |
|
IV. Fruit |
15 |
. |
. |
60 |
|
V. Milk |
||||
|
Skim |
12 |
8 |
0-3 |
90 |
|
Low-fat |
12 |
8 |
5 |
120 |
|
Whole |
12 |
8 |
8 |
150 |
|
VI. Fat |
. |
. |
5 |
45 |
You will notice symbols on some foods in the exchange groups. Foods that are high in fiber (three grams or more per normal serving) have the symbol *. High-fiber foods are good for you, and it is important to eat more of these foods.
Foods that are high in sodium (400 milligrams or more of sodium per normal serving) have the symbol #. As noted, it’s a good idea to limit your intake of high-salt foods, especially if you have high blood pressure.
If you have a favorite food that is not included in any of these groups, ask your dietitian about it. That food can probably be worked into your meal plan, at least now and then.
I. Starch/Bread List
Each item in this list contains approximately fifteen grams of carbohydrate, three grams of protein, a trace of fat, and eighty calories. Whole-grain products average about two grams of fiber per serving. Some foods are higher in fiber. Those foods that contain three or more grams of fiber per serving are identified with the symbol *.
You can choose your starch exchanges from any of the items on this list. If you want to eat a starch food that is not on the list, the general rule is this:
1/2 cup of cereal, grain, or pasta = one serving
1 ounce of a bread product = one serving
Your dietitian can help you to be more exact.
|
CEREALS/GRAINS/PASTA |
|
|
*Bran cereals, concentrated (such as Bran Buds, All Bran) |
1/3 cup |
|
*Bran cereals, flaked |
1/2 cup |
|
Bulgur (cooked) |
1/2 cup |
|
Cooked cereals |
1/2 cup |
|
Cornmeal (dry) |
2 1/2 tbsp |
|
Grape Nuts |
3 tbsp |
|
Grits (cooked) |
1/2 cup |
|
Other ready-to-eat, unsweetened (plain) cereals |
3/4 cup |
|
Pasta (cooked) |
1/2 cup |
|
Puffed cereal |
1 1/2 cups |
|
Rice, white or brown (cooked) |
1/3 cup |
|
Shredded wheat |
1/2 cup |
|
*Wheat germ |
3 tbsp |
|
DRIED BEANS/PEAS/LENTILS |
|
|
*Beans and peas (cooked) (such as kidney, white, split, blackeye) |
1/3 cup |
|
*Lentils (cooked) |
1/3 cup |
|
*Baked beans |
1/4 cup |
|
STARCHY VEGETABLES |
|
|
*Corn |
1/2 cup |
|
*Corn on the cob, 6 in. |
1 long |
|
*Lima beans |
1/2 cup |
|
*Peas, green (canned or frozen) |
1/2 cup |
|
*Plaintain |
1/2 cup |
|
Potato, baked 1 small |
(3 oz) |
|
Potato, mashed |
1/2 cup |
|
Squash, winter (acorn, butternut) |
3/4 cup |
|
Yam, sweet potato |
1/3 cup |
|
BREAD |
|
|
Bagel 1/2 |
(1 oz) |
|
Bread sticks, crisp, 4 in. long x 1/2 in. |
2 (2/3 oz) |
|
Croutons low fat |
1 cup |
|
English muffin |
1/2 |
|
Frankfurter or hamburger bun |
1/2 (1 oz) |
|
Pita, 6 in. across |
1/2 |
|
Plain roll, small |
1 (1 oz) |
|
Raisin, unfrosted |
1 slice |
|
*Rye, pumpernickel |
1 slice |
|
White (including French, Italian) |
1 slice |
|
Whole wheat |
1 slice |
|
CRACKERS/SNACKS |
|
|
Animal crackers |
8 |
|
Graham crackers, 2 1/2 in. square |
3 |
|
Matzoh |
3/4 oz |
|
Melba toast |
5 slices |
|
Oyster crackers |
24 |
|
Popcorn (popped, no fat added) |
3 cups |
|
Pretzels |
3/4 oz |
|
Rye crisp (2 in. x 3 1/2 in.) |
4 |
|
Saltine-type crackers |
6 |
|
Whole-wheat crackers, no fat added (crisp breads such as Finn, Kavli, Wasa) |
2-4 slices |
|
STARCHY FOODS PREPARED WITH FAT |
|
| Biscuit, 2 1/2 in. across |
1 |
|
Chow mein noodles |
1/2 cup |
|
Corn bread, 2-in. cube |
1 (2 oz) |
|
Cracker, round butter type |
6 |
|
French-fried potatoes (2 in. to 3 1/2 in. long) |
10 (1 1/2 oz) |
|
Muffin, plain, small |
1 |
|
Pancake, 4 in. across |
2 |
|
Stuffing, bread (prepared) |
1/4 cup |
|
Taco shell, 6 in. across |
2 |
|
Waffle, 4 1/2 in. square |
1 |
|
Whole-wheat crackers, fat added (such as Triscuits) |
4-6 (1 oz) |
II. Meat List
Each serving of meat and substitutes on this list contains about seven grams of protein. The amount of fat and number of calories vary, depending on what kind of meat or substitute is chosen. The list is divided into four parts, based on the amount of fat and calories: very lean meat, lean meat, medium-fat meat, and high-fat meat. One ounce (one meat exchange) of each of these includes the following nutrient amounts:
|
Carbohydrate |
Protein |
Fat |
Calories |
|
|
Very Lean |
. |
7 |
0-1 |
35 |
|
Lean |
. |
7 |
3 |
55 |
|
Medium-Fat |
. |
7 |
5 |
75 |
|
High-Fat |
. |
7 |
8 |
100 |
You are encouraged to use more lean and medium-fat meat, poultry, and fish in your meal plan. This will help you to decrease your fat intake, which may help decrease your risk for heart disease. The items from the high-fat group are high in saturated fat, cholesterol, and calories. You should limit your choices from the high-fat group to three times per week. Meat and substitutes do not contribute any fiber to your meal plan. Meats and meat substitutes that have 400 milligrams or more of sodium per exchange are indicated with the symbol #.
Tips
1. Bake, roast, broil, grill, or boil these foods rather than frying them with added fat.
2. Use a nonstick pan spray or a nonstick pan to brown or fry these foods.
3. Trim off visible fat before and after cooking.
4. Do not add flour, bread crumbs, coating mixes, or fat to these foods when preparing them.
5. Weigh meat after removing bones and fat and again after cooking. Three ounces of cooked meat are equal to about four ounces of raw meat. Some examples of meat portions are: 2 ounces meat (2 meat exchanges) = 1 small chicken leg or thigh, 1/2 cup cottage cheese or tuna; 3 ounces meat (3 meat exchanges) = 1 medium pork chop, 1 small hamburger, 1/2 of a whole chicken breast, 1 unbreaded fish fillet, cooked meat, about the size of a deck of cards.
6. Restaurants usually serve prime cuts of meat, which are high in fat and calories.
|
Lean Meat and Substitutes |
||
| Beef |
USDA Good or Choice grades of lean beef, such as round, sirloin, and flank steak; tenderloin; and chipped beef# |
1 oz |
| Pork |
Lean pork, such as fresh ham; canned, cured, or boiled ham#, Canadian bacon#, tenderloin |
1 oz |
| Veal |
All cuts are lean except for veal cutlets (ground or cubed) |
1 oz |
| Poultry |
Chicken, turkey, Cornish hen (without skin) |
1 oz |
| Fish |
All fresh and frozen fish |
1 oz |
|
Crab, lobster, scallops, shrimp, clams (fresh or canned in water#) |
2 oz |
|
|
Oysters |
6 med |
|
|
Tuna# (canned in water) |
1/4 cup |
|
|
Herring (uncreamed or smoked) |
1 oz |
|
|
Sardines (canned) |
2 med |
|
| Wild Game |
Venison, rabbit, squirrel |
1 oz |
|
Pheasant, duck, goose (without skin) |
1 oz |
|
| Cheese |
Any cottage cheese |
1/4 cup |
|
Grated parmesan |
2 tbsp |
|
|
Diet cheese# (with fewer than 55 calories per ounce) |
1 oz |
|
| Other |
95% fat-free luncheon meat |
1 oz |
|
Egg whites |
3 |
|
|
Egg substitutes (with fewer than 55 calories per 1/4 cup) |
1/4 cup |
|
|
Medium-Fat and Meat Substitutes |
||
| Beef |
Most beef products fall into this category. Examples are: all ground beef, roast (rib, chuck, rump), steak (cubed, Porterhouse, T-bone), and meat loaf. |
1 oz |
| Pork |
Most pork products fall into this category. (Examples: chops, loin roast, Boston butt, cutlets) |
1 oz |
| Lamb |
Most lamb products fall into this category (examples: chops, leg, roast) |
1 oz |
| Veal |
Cutlet (ground or cubed, unbreaded) |
1 oz |
| Poultry |
Chicken (with skin), domestic duck or goose (well drained of fat), ground turkey |
1 oz |
| Fish |
Tuna# (canned in oil and drained) |
1/4 cup |
| Salmon# (canned) |
1/4 cup |
|
| Cheese |
Skim or part-skim milk cheeses, such as: |
|
|
Ricotta |
1/4 cup |
|
|
Mozzarella |
1 oz |
|
|
Diet cheeses# (with 56-80 calories per ounce) |
1 oz |
|
| Other | 86% fat-free luncheon meat# |
1 oz |
|
Egg (high in cholesterol, so limit to 3 per week) |
1 |
|
|
Egg substitutes (with 56-80 calories per 1/4 cup) |
1/4 cup |
|
|
Tofu (2 1/2 in. x 2 3/4 in. x 1 in.) |
4 oz |
|
|
Liver, heart, kidney, sweetbreads (high in cholesterol) |
1 oz |
|
|
High-Fat Meat and Substitutes |
||
| Beef |
Most USDA Prime cuts of beef, such as ribs, corned beef# |
1 oz |
| Pork |
Spareribs, ground pork, pork sausage! (patty or link) |
1 oz |
| Lamb |
Patties (ground lamb) |
1 oz |
| Fish |
Any fried fish product |
1 oz |
| Cheese |
All regular cheese#, such as American, Blue, Cheddar, Monterey, Swiss |
1 oz |
| Other |
Luncheon meat#, such as bologna, salami, pimiento loaf |
1 oz |
|
Sausage#, such as Polish, Italian |
1 oz |
|
|
Knockwurst, smoked |
1 oz |
|
|
Bratwurst#! |
1 oz |
|
|
Frankfurter# (turkey or chicken) (10/lb) |
1 frank |
|
|
Peanut butter (contains unsaturated fat) |
1 tbsp. |
|
|
Count as one high-fat meat plus one fat exchange: |
||
| Frankfurter# | (beef, pork, or combination) (400 mg or more of sodium per exchange) (10/lb) |
1 frank |
III. Vegetable List
Each vegetable serving on this list contains about five grams of carbohydrate, two grams of protein, and twenty-five calories. Vegetables contain two to three grams of dietary fiber. Vegetables that contain 400 mg of sodium per serving are identified with a # symbol.
Vegetables are a good source of vitamins and minerals. Fresh and frozen vegetables have more vitamins and less added salt. Rinsing canned vegetables will remove much of the salt. Unless otherwise noted, the serving size for vegetables (one vegetable exchange) is:
1/2 cup of cooked vegetables or vegetable juice
1 cup of raw vegetables
| Artichoke (1/2 medium) |
Eggplant |
| Asparagus |
Greens (collard, mustard, turnip) |
| Beans (green, wax, Italian) |
Kohlrabi |
| Bean sprouts |
Leeks |
| Beets |
Mushrooms, cooked |
| Broccoli |
Okra |
| Brussels sprouts |
Onions |
| Cabbage, cooked |
Pea pods |
| Carrots |
Peppers (green) |
| Cauliflower |
Tomato (one large) |
| Rutabaga |
Tomato/vegetable juice |
| Sauerkraut |
Turnips |
| Spinach, cooked |
Water chestnuts |
| Summer squash (crookneck) |
Zucchini, cooked |
Starchy vegetables such as corn, peas, and potatoes are found on the Starch/Bread List.
For “free” vegetables (i.e., fewer than ten calories per serving), see the Free Food List.
# = 400 mg or more of sodium per serving.
IV. Fruit List
Each item on this list contains about fifteen grams of carbohydrate and sixty calories. Fresh, frozen, and dry fruits have about two grams of fiber per serving. Fruits that have three or more grams of fiber per serving have a * symbol. Fruit juices contain very little dietary fiber.
The carbohydrate and calorie contents for a fruit serving are based on the usual serving of the most commonly eaten fruits. Use fresh fruits or frozen or canned fruits with no sugar added. Whole fruit is more filling than fruit juice and may be a better choice for those who are trying to lose weight. Unless otherwise noted, the serving size for one fruit serving is:
1/2 cup of fresh fruit or fruit juice
1/4 cup dried fruit
|
Fresh, Frozen, and Unsweetened Canned Fruit |
|
| Apples (raw, 2 in. across) |
1 |
| Applesauce (unsweetened) | 1/2 cup |
| Apricots (canned) (4 halves) | 1/2 cup |
| Banana (9 in. long) | 1/2 |
| Blackberries (raw) | 3/4 cup |
| *Blueberries (raw) | 3/4 cup |
| Cantaloupe (5 in. across) | 1/3 |
| Cantaloupe (cubes) | 1 cup |
| Cherries (large, raw) | 12 whole |
| Cherries (canned) | 1/2 cup |
| Figs (raw, 2 in. across) | 2 |
| Fruit cocktail (canned) | 1/2 cup |
| Grapefruit (medium) | 1/2 |
| Grapefruit (segments) | 3/4 cup |
| Grapes (small) | 15 |
| Honeydew melon (medium) | 1/8 |
| Honeydew melon (cubes) | 1 cup |
| Kiwi (large) | 1 |
| Mandarin oranges | 3/4 cup |
| Mango (small) | 1/2 |
| Nectarines (2 1/2 in. across) | 1 |
| Orange (2 1/2 in. across) | 1 |
| Papaya | 1 cup |
| Peach (2 3/4 in. across) | 1 |
| Peaches (canned) (2 halves) | 1 cup |
| Pear (1/2 large) | 1 small |
| Pears (canned) (2 halves | 1/2 cup |
| Persimmon (medium, native) | 2 |
| Pineapple (raw) | 3/4 cup |
| Pineapple (canned) | 1/3 cup |
| Plum (raw, 2 in. across) | 2 |
| *Pomegranate | 1/2 |
| *Raspberries (raw) | 1 cup |
| *Strawberries (raw, whole) | 1 1/4 cup |
| Tangerine (2 1/2 in. across) | 2 |
| Watermelon (cubes) | 1 1/4 cup |
|
*Dried Fruit |
|
| *Apples | 4 rings |
| *Apricots | 7 halves |
| Dates (medium) | 2 1/2 |
| *Figs | 1 1/2 |
| *Prunes (medium) | 3 |
| Raisins | 2 tbsp |
|
Fruit Juice |
|
| Apple juice/cider | 1/2 cup |
| Cranberry juice cocktail | 1/3 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 |
| * = 3 grams or more of fiber per serving | |
V. Milk List
Each serving of milk or milk products on this list contains about twelve grams of carbohydrate and eight grams of protein. The amount of fat in milk is measured in percent of butterfat. The calories vary depending on the kind of milk chosen. The list is divided into three parts, based on the amount of fat and calories: skim/very low-fat milk, low-fat milk, and whole milk. One serving (one milk exchange) of each of these includes:
|
Milk
|
Carbohydrate |
Protein |
Fat |
Calories |
|
Skim |
12 |
8 |
trace |
90 |
|
Low-fat |
12 |
8 |
5 |
120 |
|
Whole |
12 |
8 |
8 |
150 |
Milk is the body’s main source of calcium, the mineral needed for growth and repair of bones. Yogurt is also a good source of calcium. Yogurt and many dry or powdered milk products have different amounts of fat. If you have questions about a particular item, read the label to find out the fat and calorie content.
Milk can be drunk or added to cereal or other foods. Many tasty dishes, such as sugar-free pudding, are made with milk (see the Combination Foods list). Add life to plain yogurt by adding one of your fruit servings to it.
|
Skim and Very Low-Fat Milk |
|
|
Skim milk |
1 cup |
| 1/2% milk |
1 cup |
|
1% milk |
1 cup |
|
Low-fat buttermilk |
1 cup |
|
Evaporated skim milk |
1/2 cup |
| Dry nonfat milk | 1/3 cup |
|
Plain nonfat yogurt |
8 oz |
|
Low-Fat Milk |
|
|
2% milk |
1 cup |
|
Plain low-fat yogurt (with added nonfat milk solids) |
8 oz |
|
Whole Milk |
|
|
Whole milk |
1 cup |
|
Evaporated whole milk |
1/2 cup |
|
Whole milk plain yogurt |
8 oz |
VI. Fat List
Each serving on the fat list contains about five grams of fat and forty-five calories.
The foods on the fat list contain mostly fat, although some items may also contain a small amount of protein. All fats are high in calories and should be carefully measured. Everyone should modify fat intake by eating unsaturated fats instead of saturated fats. The sodium content of these foods varies widely. Check the label for sodium information.