Using Exchange Lists for Diabetes Meal Planning

If you have diabetes, it’s essential to have a road map for your diet. This road map is a meal plan, and you can either create it by yourself or enlist the help of a registered nutritionist, dietician or certified diabetes educator. The goal of a meal plan exchange lists is to help control your blood sugar and lose weight by balancing the type and amount of food you eat. Diabetics should follow a diet low in carbohydrates, fat and calories.

Diabetic Exchange List Food Groups

Exchange lists, which were created by the American Dietetic Association and the American Diabetes Association as a meal planning guide primarily for diabetics, are based on principles of good nutrition that apply to everyone. The foods within each group have similar amounts of calories, carbs, fats, and proteins, which allows for greater flexibility in choosing foods. The lists group foods into three basic groups and sub-groups:

  • Carbohydrates
    • Starch: One exchange contains about 15 grams of carbs, up to 3 grams of protein, up to 1 gram of fat, and 80 calories. Plus, whole grain foods average about 2 grams of fiber per serving.
    • Fruit: One exchange contains about 15 grams of carbs, no protein or fat, and 60 calories. Plus, fresh, frozen and dry fruits have about 2 grams of fiber per serving.
    • Vegetables(non-starchy): One exchange contains 5 grams of carbs, 2 grams of protein, no fat and only 25 calories, plus2-3 grams of dietary fiber.
    • Milk: One exchange contains about 12 grams of carbs and 8 grams of protein, plus:
      • Fat-free or low-fat = 0-3 grams of fat and 90 calories
      • Reduced fat = 5 grams of fat and 120 calories
      • Whole milk = 8 grams of fat and 150 calories
    • Other carbs (desserts, sweets)
  • Meats and meat substitutes: One exchange has 7 grams of protein, plus:
    • Very lean meats = 0-1 grams fat and 35 calories
    • Lean meats= 0 to 3 grams of fat and 55 calories
    • Medium-fat meats= 4 to 7 grams of fat and 75 calories
    • High-fat meats = 8 or more grams of fat and 100 calories
  • Fats: One fat exchange equals 5 grams of fat and 45 calories
    • Monunsaturated fats
    • Polyunsaturated fats
    • Saturated fats

In addition, any food or drink that has less than 20 calories and 5 grams or less of carbohydrate a serving is considered a free food. If they do not specify a serving size, you can consume them in any moderate amount as often as you’d like.

For the serving sizes listed, all choices on each list are considered equal in nutrients and the effect they have on blood sugar, so one food can be “exchanged” for another food on the list. That way, you can pick and choose the foods you prefer from each list.

Your best bet is to meet with a dietician, who can create a meal plan for you that includes the appropriate number of calories and units of each exchange category you should eat daily.

Based on your needs and preferences, your dietitian will recommend a certain number of daily exchanges from each food group, as well as the best times of the day to eat meals and snacks. Spreading exchanges throughout the day will help you keep your blood sugar level within your target range.

Visit the American Dietetic Association website to order a copy of the exchange list book, or you can explore over 5,000 different foods online with the American Diabetes Association’s MyFoodAdvisor™.

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