What Is the Diabetic Exchange List

An Overview of Exchanges and How They Are Used

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When you have diabetes, figuring out what to eat can be a challenge. Diabetic exchange lists are one tool that's widely used for meal planning with diabetes. (Two other popular methods are carb counting and the "create your plate" method.) This article gives you an overview of what diabetic exchange lists are and how they are used.

What Are Exchanges?

In the diabetic exchange list, foods are clustered into categories that all have about the same amount of carbohydrates and calories per serving.

Categories include

  • Vegetables
  • Fruit
  • Very Lean Proteins
  • Lean Proteins
  • Medium-Fat Proteins
  • Starches
  • Fat-Free and Very Low-Fat Milk
  • Fat

How Are Exchanges Used in Meal Planning?

When using the exchange list method of diabetic meal planning, your dietitian creates a meal plan for you that tells you how many "exchanges" you should eat from each food group at your meals and snacks. So, for instance, you might be told that you can eat one fruit exchange and one fat-free milk exchange for a snack. Which foods you choose is up to you, as long as you're picking foods from the specified exchanges.

The Role of Serving Size

Understanding serving size is an important part of meal planning from exchange lists. Serving sizes are established that keep all foods within a group at approximately the same amount of calories and fat, as well as grams of carbohydrates. When starting out, it may be helpful for you to weigh foods on a food scale and/or use measuring cups to measure your food.

As you become more familiar with what various serving sizes look like, you may be able to eyeball it.

Pros and Cons of Using Diabetic Exchange Lists

Exchange lists can simplify meal planning and ensure a consistent, nutritionally balanced diet. If you are on insulin, following an exchange diet makes it easier to figure out your ratio of carbs to insulin doses.

Exchanges also add variety to your diet. You can swap one food in a group for another in the same group when you are making your food choices.

On the other hand, some people find exchange list method too rigid and hard to follow when eating foods that don't fall inside exchange categories (for example, mixed dishes or dessert). Exchange lists have fallen out of favor by many dietitians. Other methods, including carb counting and the plate method have become more popular, as they are seen to offer more flexibility for food choices.

General Exchange List Chart

This chart gives you a general sense of the major exchanges, their serving sizes, calories, carbohydrates and fat. For more detailed information on specific food items, check out this extensive exchange list. Looking at a more detailed list is particularly handy for figuring out the difference in serving sizes for exchanges that show a range.

Current Food Exchange Categories and Values
Type of FoodServing Size*CaloriesCarbohydratesFat
Vegetables1/2 cup - 1 cup255 grams0
Fat-Free or Very Lowfat Milk3/4-1 cup90120
Very Lean Protein1 oz. (varies)3501
Lean Protein1 oz. (varies)5502-3
Medium Fat Protein1 oz. (varies)7505
Fruits1 piece, 1/2-1 cup60150
Fats1 tsp, 1-2 tbls.4505



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