A “food exchange” is just what the words imply (exchange is also referred to as a choice, serving, or substitution).
It allows a person to exchange one food for another on a list with any other food item on the same list, with each list having measured or weighed foods that have about the same nutritional level.
For instance, looking at the samples below, a person can eat one small apple or half a mango, with either serving being 15 grams of carbohydrate and 60 calories.
In order to determine how many calories, carbohydrates, proteins, and fats a person can eat at each meal, along with snacks, much larger lists are available (at places such as the University of California at San Francisco’s Diabetes Teaching Center at https://dtc.ucsf.edu/living-with-diabetes/diet-and-nutrition/understanding-food/ ).
Although there are books and Internet sites that offer listings and how to work with food exchanges, the American Diabetes Association also recommends that a registered dietitian be consulted in order to help the person with diabetes understand the complexity of such food exchanges, and to obtain better and more balanced nutritional information.
There are many lists of food exchanges on the Internet. The following is only a sampling of an exchange list, as per the U.S. Department of Health and Human Services’ National Heart, Lung, and Blood Institute (to obtain more information about this listing link to https://www.nhlbi.nih.gov/health/educational/lose_wt/eat/fd_exch.htm ):
Vegetables contain 25 calories and 5 grams of carbohydrate. One serving equals
½ C
Cooked vegetables (carrots, broccoli, zucchini, cabbage, etc.)
1 C
Raw vegetables or salad greens
Fat-Free and Very Low-Fat Milk contain 90 calories per serving. One serving equals:
1 C
Milk, fat-free or 1% fat
½4 C
Yogurt, plain nonfat or low-fat
Very Lean Protein choices have 35 calories and 1 gram of fat per serving. One serving equals:
1 oz
Turkey breast or chicken breast, skin removed
1 oz
Fish fillet (flounder, sole, scrod, cod, etc.)
1 oz
Canned tuna in water
Egg whites
Fruits contain 15 grams of carbohydrate and 60 calories. One serving equals
1 small
Apple, banana, orange, nectarine
Grapefruit
Mango
1C
Fresh berries (strawberries, raspberries, or blueberries)
Lean Protein choices have 55 calories and 2, 3 grams of fat per serving. One serving equals:
1 oz
Chicken, dark meat, skin removed
1 oz
Turkey, dark meat, skin removed
1 oz
Salmon, swordfish, herring
1 oz
Lean beef (flank steak, London broil, tenderloin, roast beef) 1 oz
Veal, roast, or lean chop 1 oz
Pork, tenderloin, or fresh ham Limit to 1, 2 times per week
Medium-Fat Proteins have 75 calories and 5 grams of fat per serving. One serving equals:
1 oz
Beef (any prime cut), corned beef, ground beef 1
Whole egg (medium) 1 oz
Mozzarella cheese
4 oz
Tofu (note this is a heart healthy choice)
Choose these very infrequently
Starches contain 15 grams of carbohydrate and 80 calories per serving. One serving equals:
1 slice
Bread (white, pumpernickel, whole wheat, rye)
English muffin
¾ C
Cold cereal
⅓ C
Rice, brown or white, cooked
Fats contain 45 calories and 5 grams of fat per serving. One serving equals
1 tsp
Oil (vegetable, corn, canola, olive, etc.)
1 tsp
Butter
1 tsp
Mayonnaise
1 tbsp
Salad dressing
(Source: Based on American Dietetic Association Exchange Lists presented by the National Heart, Lung, and Blood Institute.)