The Exchange List


diabetes.002

By: Nikki Nies

Last fall, I was assigned to try different food tools to track one’s eating habits.  Everything from the DASH diet to Choosemyplate.  The hardest tool to use was the Exchange List, which was created to help those with diabetes track their daily intake of varied amounts of nutrients.

By following the exchange system, one keep his or her blood sugar levels in the target range, with a specific amount of carbohydrates, fat and protein consumed daily.   It’s essential to track how many carbohydrates are consumed as too much can cause blood sugar levels to spike, while a recommended amount is needed to consume essential nutrients and vitamins.

A carbohydrate choice is a  portion of a carbohydrate that is equal to 15 grams of carbohydrates.  For example, 1 slice of bread=15 g of carbohydrates.  The amount of carbohydrates needed for  one depends on one’s body composition, physical activity level and/or weight management.

Foods that contain carbohydrates:

  • Grains—bread, crackers, noodles, rice, cereal, oatmeal, pasta, tortillas
  • Starchy vegetables—potatoes, peas, corn, winter squash, corn, lentils and beans
  • Fruit
  • Juices
  • Milk
  • Yogurt
  • Desserts—ice cream

How to determine carbohydrate choice:

  1. Looking at Nutrition Facts—look at serving size
  2. Find the total carbohydrate in 1 serving
  3. Compare serving size to actual portion
  4. Count the grams of carbohydrate

Each Portion=15 grams of carbohdyrates

Grains Dairy Fruits Vegetables and Beans Sweets and Desserts Free*
1 slice bread 1 cup milk ½ medium banana or apple ½ potato, sweet potatoes, peas, corn ¾ oz. snack—pretzels Spices
¼ large bagel 1 cup low fat or skim ilk ½ cup canned fruit in own juice ½ cup cooked garbanzo, kidney and black beans 4-6 crackers Seasonings
6” tortilla 1 cup of low fat or fat free plain yogurt 1 cup melon 1 cup winter squash 15 potato chips Sugar substitutes
1 cup soup 6 oz. flavored yogurt with low calorie sweetener 2 tablespoons of dried fruit 1 ½ cups cooked vegetables 5 vanilla wafers Sugar free beverages
1/3 cup cooked rice or pasta 1 cup raspberries 1 cup cabbage, celery, cucumber, green onion, hot peppers, mushrooms, radishes, endive, spinach, lettuce 2 small sandwich cookies Bouillon
¾ oz. unsweetened cold cereal 1 ¼ cup strawberries ½ cup regular ice cream Club soda
½ cup cooked cereal ¾ cup blackberries 1 tablespoon of sugar or honey Coffee
3 cups air popped popcorn ¾ cup blueberries Tea
½ cup fruit juice Cocoa powder, unsweetened

*Considered free since there are less than 20 calories; less than 5 grams of carbohydrates

How to choose “better” carbs:

  • Choose whole fruits instead of fruit juices, canned or sugar covered fruits
  • Opt for whole grain bread, pasta and rice
  • Use variety with quinoa, oatmeal, barley and bulgur

It’s recommended women consume 3-4 carb choices at every meal (approx. 45-60 grams).  It’s recommended men consume 4-5 carbohydrate choices at every meal (approx. 60-75 grams of carbohydrates.

Although there are many resources available at one’s disposal online, it would be in the best interest of any one using the exchange list to consult a physician or RD to review dietary needs, develop a meal plan and/or clear up any questions.

If taking insulin and/or diabetes medications, it’s important to eat at about the same time daily.

I believe I finally have a better grasp on the exchange list.  Having the exposure for class was a great, but now that I’ve had the time to really look at the Exchange List and understand the portions in relation to carbohydrate choice, I’m more confident in my ability to explain the system to those interested in using the Exchange List.

A great resource: http://fnic.nal.usda.gov/diet-and-disease/diabetes/carbohydrate-counting-and-exchange-lists

Sources: http://www.mayoclinic.com/health/diabetes-diet/DA00077

Click to access The%20Diabetic%20Exchange%20List.pdf

http://www.faqs.org/nutrition/Erg-Foo/Exchange-System.html

http://www.nhlbi.nih.gov/health/public/heart/obesity/lose_wt/fd_exch.htm

Click to access ADA_Carbohydrate%20counting_large%20print_FINAL.pdf

http://www.nhlbi.nih.gov/health/public/heart/obesity/lose_wt/fd_exch.htm

Click to access ADA_Carbohydrate%20counting_large%20print_FINAL.pdf

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