Health Fitness

Diabetic Food Exchange

Summary

The Diabetic Food Exchange is a food categorization system to make meal planning easier for people with diabetes. The system groups foods according to their nutritional values, helping diabetics to eat nutritionally balanced meals consistent with carbohydrates for glucose (blood sugar) control and overall health.

The American Diabetes Association and the American Dietetic Association gave the method its motto. It classifies foods into three groups based on carbohydrate content:

  • carbohydrate group
  • Group of meats and meat substitutes
  • fat group

Furthermore, foods can be classified into six groups based on their nutritional value:

  • starch/bread
  • Fruit
  • Milk
  • vegetables
  • Meat and meat substitutes
  • fat

Each exchange (serving) of food within a food group has about the same amount of carbohydrate. The amounts of protein, fat and calories can vary. Patients on special diets can use these food groups to interchange foods within the same list knowing that each food will have approximately the same effect on their glucose level.

About the diabetic food exchange

The diabetic food exchange is a method of sorting foods into groups that share a similar carbohydrate content. Calories, protein content, and fat content may vary. This can help people with diabetes plan a variety of well-balanced meals that help keep glucose (blood sugar) levels within the normal range.

Established by the American Diabetes Association and the American Dietetic Association, the system classifies foods into the following groups based on their carbohydrate content:

  • carbs
    • Starches/breads
    • fruits
    • Milk
    • other carbohydrates
    • non-starchy vegetables

  • Meat and meat substitutes
    • very thin
    • Bend down
    • medium fat
    • rich in fat
    • Fats (includes monounsaturated, polyunsaturated, and saturated)

Diabetes patients can choose items from a food list knowing that they are consuming a specific amount of carbohydrate, protein, fat, and calories. In this way, patients can substitute certain foods in their diet for others from the same list.

Most foods are allowed as part of the exchange diet, as long as they are eaten within certain serving and serving limitations per day. Patients should work with their doctor and a registered dietitian to design their meal plan. The ideal plan incorporates a variety of foods from the different food groups and lists an adequate number of exchanges for three meals and two to three snacks each day.

types and differences

The diabetic food exchange lists allow patients to create a well-balanced diet that offers a variety of options. The foods that make up these lists are divided into several categories, and any item within a category can be substituted for another food on that list.

The number and type of exchanges people can have at each meal will be determined by their doctor and registered dietitian. The patient’s age, gender, weight, height, consistent activity levels, and personal eating styles will be considered.

Exchanges vs. Carb Counting

People with diabetes should plan their diet in consultation with a doctor and a registered dietitian. Once an eating plan has been established, the main methods patients use to track their carbohydrates are diabetic food exchange lists or carbohydrate (“carb”) counting.

There are advantages and disadvantages to each method. Diabetic Food Exchanges offer patients a simple way to plan a balanced diet with a variety of options, while ensuring adequate carbohydrate intake. They are likely to appeal to patients who like built-in structure in their meal planning.

On the other hand, some may find the range of options on exchange listings too limited. This is especially true for those who like to experiment with cooking, although many diabetic cookbooks break down recipes by the number of exchanges in one serving.

The carbohydrate counting method is used to calculate the amount of insulin needed to convert a meal into energy. This is done by adding the amount of carbohydrate, in grams, into the meal that the patient is preparing to eat. The added numbers come from the carbohydrate column of the diabetic exchange list.

Meanwhile, people who use carb counting can experiment with more varied food types and often find it more flexible than diabetic swaps. However, patients using this method instead of the diabetic food exchange should be more vigilant in planning well-balanced meals. Carb counting also involves math, which can be inconvenient for some. For more information on carbohydrate counting, see carbohydrates.

Other methods that some people use include the glycemic index and load, the diabetes food pyramid, and the “rate your plate” system.

Questions for your doctor

Preparing questions ahead of time can help patients have more meaningful conversations with their healthcare providers about their conditions. Patients may want to ask their doctor the following questions about diabetic food exchange:

Which method is better for me: the exchange list or the carbohydrate count?

Can either method be used with my favorite recipes?

Does carb counting have more flexibility for me compared to exchange lists?

If I misuse the carb counting method and accidentally take too much insulin, what should I do?

What should I do if I take too little insulin?

I noticed that all the meats are grouped into one category. Does that mean they are all the same?

I notice that three forms of milk are grouped into one category. Does that mean that they are all equivalent to each other?

How are “natural” sugars like those found in fruit different from refined sugar added to desserts?

Should I include or avoid the other category of carbohydrates?

Will you help me find a qualified dietitian to explain my dietary guidelines?

What other resources are available to learn about diabetes exchanges?