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Diabetes: Exchange List

What are the exchange lists?

The exchange meal plan divides foods into starch, fruit, milk, vegetable, meat, and fat groups. The plan gives you serving sizes for foods in each group that have about the same amount of carbohydrate, protein, fat, and calories. This lets you or your child exchange, or swap, choices from a food list. The number of servings from each food group that your child should eat is based on how many calories your child needs each day.

A dietitian will help you plan how much food your child should eat at each meal and from what lists the foods should come from. The exchange meal plan is very flexible, and is helpful if your child is overweight and need to keep track of calories.

The following list is a sample of foods found on the exchange lists.

Carbohydrate group

Starch List: One starch exchange contains about 15 grams of carbohydrate, 3 grams of protein, 0 to 1 grams of fat, and 80 calories. A starch exchange is sometimes called a carb exchange and includes food such as bread, potatoes, rice, and corn.

Fruit List: 1 fruit exchange contains about 15 grams of carbohydrate and 60 calories.

Milk List: 1 milk exchange contains about 8 grams of protein and 12 grams of carbohydrate.

Vegetable List: One vegetable exchange has 5 grams of carbohydrate, 2 grams of protein, no fat, and 25 calories. One-half cup of cooked or a cup of raw vegetables is a good measure for 1 exchange of most vegetables. Raw lettuce may be taken in larger quantities, but salad dressing usually equals 1 fat exchange.

Meat and Meat Substitute Group

Meats are divided into very lean meats, lean meats, medium-fat meats, and high-fat meats. People with diabetes should try to eat more lean and medium fat meats and stay away from the high fat choices. The leaner the meat, the fewer the calories and fat. All meat exchanges have 7 grams of protein for 1 meat exchange.

Fat Group

Fat List: Your body needs the right kind and the right amount of fat to work properly. 1 fat exchange contains 5 grams of fat and 45 calories. The monounsaturated fats and polyunsaturated fats are healthier than saturated fats.

Free Foods

A free food contains less than 20 calories or less than 5 grams of carbohydrate per serving. If the food has a serving size listed on its package, it should be limited to 3 servings spread throughout the day.

Combination Foods

Many foods, such as casseroles, are mixed together. Your dietitian can help you figure out how many exchanges to count for combination foods. For example:

  • Lasagna (1 cup) = 2 carb exchanges and 2 medium-fat meat exchanges
  • Spaghetti with meatballs (1 cup) = 2 carb exchanges and 2 medium-fat meat exchanges
  • Pizza, cheese (1/4 of 12 in.) = 2 carbs, 2 medium-fat meats
  • Chicken noodle soup (1 cup) = 1 carb exchange
  • Frozen entrée (less than 300 calories) = 2 carbs, 3 lean meat exchanges
  • Macaroni and cheese (1 cup) = 2 carb exchanges and 2 medium-fat meat exchanges

For books that help you with exchange food groups and other information to help manage diabetes, contact:

Developed by RelayHealth.
Pediatric Advisor 2015.3 published by RelayHealth.
Last modified: 2013-03-03
Last reviewed: 2014-06-20
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
Copyright ©1986-2015 McKesson Corporation and/or one of its subsidiaries. All rights reserved.
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