Diabetic Exchanges

I am a new diabetic and am not sure I understand Diabetic Exchanges. —P.L., Casselberry, Florida

Reading those numbers can be a bit tricky! Diabetic Exchanges are included to help you see how the foods fit into your daily meal plan. Exchange lists categorize foods into these main groups:

  • Bread/starch
  • Meat/protein
  • Fruits
  • Vegetables
  • Milk
  • Fats

Exchange foods (foods in the bread/ starch group, in the meat/protein group, etc.) are listed together because they are nutritionally comparable. That is, each measured serving of food on that list has about the same amount of carbohydrate, protein, fat and calories as do the other foods on that list. Therefore, any of those foods can be “exchanged” or traded for another food on the same list. For example, a slice of bread for breakfast could be traded for 1/2 cup of cooked cereal if you preferred. Either would be equal to 1 starch. However, some foods may not seem to belong to the exchange group to which they have been assigned. The following are some examples:

  • Many non-meat foods appear as meat exchanges because of their protein and fat levels. Cheese and peanut butter are two common examples.
  • Vegetable exchanges do not include all vegetables. For example, vegetables such as lima beans, peas and corn are listed as bread/starch exchanges because of their carbohydrate and protein content.
  • To add to the confusion, not all bread/starch exchanges are breads. This group also includes starchy vegetables, cereals, pasta and other grain products.
Here’s an example of the equivalent of one bread/starch exchange: 1 slice of bread = 1/2 English muffin = 1 (6-inch) corn tortilla = 1/2 cup cooked pasta = 1/2 cup unsweetened ready-to-eat cereal.

Even though some foods do not have meat in them, those combined in a recipe may contain enough protein to count as a meat exchange. Remember, protein can be found in many foods—beans, cheese and even a small amount in noodles and vegetables. One meat exchange is 7 grams of protein or the equivalent of just 1 ounce of meat. Getting back to your original question about the Meatless Spaghetti Sauce… even though there is a higher percentage of carbohydrate to protein in the starch (noodles) and vegetable (tomato sauce) exchanges, there is also some protein in these groups—enough to list 1 lean meat.