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Diabetes: Exchange List

What are the exchange lists?

The exchange lists show you portions of food that equal 1 exchange. Foods are divided into food lists. The foods on each list are called exchanges because they have a similar number of calories, protein, carbohydrate, and fat content. Foods from each list can be traded or "exchanged" for any other food on the same list because they all have a similar exchange value. 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.

At first you should measure your food until you are able to make good estimates about serving sizes. The following list is a sample of foods found on the exchange lists.

For more information, you can buy the Exchange Lists for Meal Planning from:

The American Diabetes Association
P.O. Box 930850
Atlanta, GA 31193

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.

Examples of one starch (carb) exchange are:

  • one slice of bread
  • 1/2 hamburger or hot dog bun
  • 3/4 cup of unsweetened cereal
  • 1/3 cup pasta
  • 3 cups popcorn
  • crackers (6 small saltines, 3 squares of graham crackers, 3 of most other crackers)
  • 1 pancake or waffle (5 inch)
  • 15 to 20 fat-free or baked potato or corn chips.

The vegetables included in the starch exchanges include:

  • corn (1/2 cup or 1/2 cob)
  • white potato (1/4 large baked with skin or 1/2 cup mashed)
  • yam or sweet potato (1/2 cup)
  • green peas (1/2 cup)
  • squash, winter (1 cup)
  • lima beans (2/3 cup).

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

Examples of one fruit exchange are:

  • grape juice (1/3 cup)
  • apple or pineapple juice (1/2 cup)
  • orange or grapefruit juice (1/2 cup)
  • 1 small apple
  • orange or peach
  • 1/2 banana
  • 1 cup raspberries
  • 1/3 of a small cantaloupe
  • 1 slice of watermelon.

Milk List: 1 milk exchange contains about 8 grams of protein and 12 grams of carbohydrate. Items on the milk list are divided into fat-free, reduced fat, and whole milk depending on the number of fat grams in the exchange.

Examples of one milk exchange are:

Fat-Free (0 to 3 grams of fat)

  • 1 cup of skim or non-fat milk
  • 1 cup of 1% milk (also includes 1/2 fat exchange)
  • 6 ounces flavored fat-free yogurt

Reduced-Fat (5 grams of fat)

  • 6 ounces of plain, low-fat yogurt
  • 1 cup 2% milk (also includes one fat exchange).

Whole Milk (8 grams of fat)

  • 8 ounces of plain yogurt (made from whole milk)
  • 1 cup whole milk.

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.

Other Carbohydrates List: One "other carbohydrate" exchange has 15 grams of carbohydrate. Many of these foods count as a starch exchange and one or more fat exchanges.

  • brownie (2 inch square) = 1 carb, 1 fat exchange
  • fruit snack roll = 1 carb exchange
  • granola bar = 1 and 1/2 carb exchanges
  • ice cream (1/2 cup) = 1 carb, 2 fat exchanges
  • frozen yogurt (1/2 cup) = 1 carb, 0 to 1 fat exchanges
  • tortilla chips (6-12) = 1 carb, 2 fat exchanges.

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 Very Lean meat group includes foods that contain 7 grams of protein, 0 to 1 gram of fat, and 35 calories for 1 exchange. Examples include:

  • 1 ounce chicken or turkey (white meat, no skin)
  • 1 ounce fresh fish
  • 1 ounce fat-free cheese
  • 2 egg whites

The Lean meat group includes foods that contain 7 grams of protein, 3 grams of fat, and 55 calories for 1 meat exchange. Examples include:

  • 1 ounce chicken or turkey (dark meat, no skin)
  • 1 ounce fish
  • 1 ounce lean pork
  • 1 ounce USDA Select or Choice grades of lean beef
  • 1 ounce cheese (with 3 grams of fat or less per ounce).

The Medium-Fat group includes foods that have 7 grams of protein, 5 grams of fat, and 75 calories for 1 meat exchange. Examples include:

  • 1 ounce of ground beef, most cuts of beef, pork, lamb or veal
  • 1 ounce of cheese (5 grams of fat per ounce or less)
  • 1 egg
  • 1 ounce fried fish.

The High-Fat foods have 7 grams of protein, 8 grams of fat, and 100 calories for 1 meat exchange. This group includes:

  • 1 ounce of pork sausage
  • 1 ounce of spare ribs
  • 1 oz of regular cheese (American, Swiss etc.)
  • 1 oz of lunch meat
  • 1 hot dog (turkey or chicken).

Fat Group

Fat List: Fat is necessary for the body and is particularly important during periods of fasting (overnight), when it is very slowly absorbed. 1 fat exchange contains 5 grams of fat and 45 calories. The monounsaturated fats and polyunsaturated fats are better for us than saturated fats. The fat list includes:

1 exchange of monounsaturated fats equals:

  • 1/2 Tbsp peanut butter
  • 6 almonds
  • 1 tsp of oil (olive, peanut, canola).

1 exchange of polyunsaturated fats equals:

  • 1 tsp margarine
  • 1 tsp of any vegetable oil (except coconut).

1 exchange of saturated fat includes:

  • 1 tsp butter
  • 1 strip of bacon
  • 2 Tbsp of cream (half and half).

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. Examples of free foods include:

  • 4 Tbsp fat-free margarine
  • 1 Tbsp fat-free Miracle Whip
  • sugar-free gelatin
  • diet soft drinks
  • catsup
  • soy sauce
  • spices.

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.
Developed by McKesson Provider Technologies.
Published by McKesson Provider Technologies.
Last modified: 2006-10-05
Last reviewed: 2005-12-05
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 © 2006 McKesson Corporation and/or one of its subsidiaries. All Rights Reserved.
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