Diabetes Food Swap System
Another tool your dietitian may bring into play is the food exchange system, which looks beyond carbohydrates at the diet as a whole, organizing foods into several groups—generally breads and starches, fruits, vegetables, milk, meat and protein-based substitutes, fats, and other carbohydrates like sweets. While food exchanges are designed for people with diabetes, many nutritionists find them valuable for anyone trying to control calories, reduce fat, and eat a balanced diet.
The idea behind the exchange system is that every item within a given category is nutritionally equivalent to every other item on that same list—providing roughly the same amount of carbohydrate, fat, protein, and calories. Using the portion sizes laid out on the lists is important for making the system work. But the big advantage is that—as with carbohydrate counting—you have a lot of flexibility in choosing foods within each category, as long as they add up to the nutritional budget allowed in your meal plan. Fortunately, portion sizes for many of the groups tend to be similar, which helps give you an intuitive grasp of how much you should eat. One bread/ starch exchange, for example, is usually measured in slices or half cups (as are many vegetable exchanges). One meat exchange is about one ounce—much smaller, by the way, than the two to three ounces that typically constitute a serving.
The exchange system strives to give you a range of nutrients from a variety of foods, but it does so with greater precision. Still, using the exchange system requires guidance. Your dietitian can help you figure out how many exchanges from each group you should eat.
The groupings themselves may take some getting used to because they’re organized by calorie and nutrient content rather than source. Cheeses, for instance, are listed with meats rather than milk because their protein and fat makeup are more similar. Corn, green peas, and potatoes appear with starches rather than vegetables because of their high carbohydrate content. Once you’re familiar with the system, however, its combination of flexibility and consistency can help you keep blood sugar down while providing enough nutrients.
Ranges of Exchanges
Some exchange lists are subdivided into groups that specify exchanges of, say, very lean meats and substitutes (separate from high-fat meats), or nonfat-milk products (separate from whole-milk products). Foods within each category are nutritionally equivalent in the exchange system.
One slice white bread, ½ cup cooked lentils, ½ cup cooked pasta, ½ cup corn, one small potato
½ cup cooked carrots, ½ cup cooked green beans, 1 cup raw radishes, 1 cup raw salad greens, 1 large tomato
One small banana, 1 large pear, seven small grapes, 2 tablespoons raisins, ½ cup fruit cocktail
Very lean meats and substitutes
1 ounce skinless chicken breast, 1 ounce canned tuna (in water), 1 ounce fat-free cheese, ¼ cup low-fat cottage cheese, two egg whites
Nonfat and very-low-fat milks
1 cup skim milk, 1 cup plain nonfat yogurt, ½ cup nonfat fruit-flavored yogurt (containing nonnutritive sweetener), ½ cup evaporated nonfat milk, 1 cup nonfat buttermilk
One 2-inch-square brownie, two small cookies, 1 tablespoon 100 percent fruit spread, ½ cup gelatin, five vanilla wafers