The diabetic patient's meal plan should specify that he or she can have specific numbers of exchanges; for example, a typical lunch may allow two bread, two meat, one fat, two vegetable, and one fruit portion. By referring to a list of exchanges, the person can develop his or her own menu. The idea is that by following the exchange system, the person will automatically pirate distribution of carbohydrates, protein, and fats.

Many diabetic patients find the exchange system convenient and workable. For others, however, it is better in theory than in actuality. For example, ethnic and convenience foods may be difficult to find on a standard exchange list. Most processed foods will have a number of different exchanges, and keeping track of them is more than many people can cope with.

Most of the recipes featured in The Diabetic Gourmet Magazine and The Diabetic Newsletter feature exchange information in addition to traditional nutritional information, such as calories, fat, and carbohydrates. This should make it easy to incorporate new recipes into your meal plan.

Some dietitians and diabetes educators stress working with exchanges; others will teach patients how to estimate percentages of carbohydrates, fats and protein in a meal and then tailor portions to fit their overall meal plan. In either event, the meal plan should be based on a system that the patient (or person who prepares the meals) understands. It also should take into account individual food preferences and lifestyles.

Within each group below, the foods can be exchanged for each other. You can use the lists below to give yourself more choices.

Vegetables
Fat-Free and Very Lowfat Milk
Very Lean Protein
Fruits
Lean Protein
Medium Fat Proteins
Starches
Fats
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Vegetables

Contain 25 calories and 5 grams of carbohydrate.
One serving equals:

1/2 cup Cooked vegetables (carrots, broccoli, zucchini, cabbage, etc.)
1 cup Raw vegetables or salad greens
1/2 cup Vegetable juice
If you?re hungry, eat more fresh or steamed vegetables.


Fat-Free and Very Lowfat Milk

Contain 90 calories per serving.
One serving equals:

1 cup Milk, fat-free or 1% fat
3/4 cup Yogurt, plain non fat or low fat
1 cup Yogurt, artificially sweetened


Very Lean Protein

Choices have 35 calories and 1 gram of fat per serving.
One serving equals:

1 ounce Turkey breast or chicken breast, skin removed
1 ounce Fish fillet (flounder, sole, scrod, cod, etc.)
1 ounce Canned tuna in water
1 ounce Shellfish (clams, lobster, scallop, shrimp)
3/4 cup Cottage cheese, non fat or low fat
2 each Egg whites
1/4 cup Egg substitute
1 ounce Fat-free cheese
1/2 cup Beans- cooked (black beans, kidney, chick peas or lentils): count as 1 starch/bread and 1 very lean protein


Fruits

Contain 15 grams of carbohydrate and 60 calories.
One serving equals:

1 small Apple, banana, orange, nectarine
1 medium Fresh peach
1 Kiwi
1/2 Grapefruit
1/2 Mango
1 cup Fresh berries (strawberries, raspberries or blueberries)
1 cup Fresh melon cubes
1/8 th Honeydew melon
4 ounces Unsweetened Juice
4 teaspoons Jelly or Jam


Lean Protein

Choices have 55 calories and 2-3 grams of fat per serving.
One serving equals:

1 ounce Chicken- dark meat, skin removed
1 ounce Turkey- dark meat, skin removed
1 ounce Salmon, Swordfish, herring
1 ounce Lean beef (flank steak, London broil, tenderloin, roast beef)*
1 ounce Veal, roast or lean chop*
1 ounce Lamb, roast or lean chop*
1 ounce Pork, tenderloin or fresh ham*
1 ounce Low fat cheese (3 grams or less of fat per ounce)
1 ounce Low fat luncheon meats (with 3 grams or less of fat per ounce)
1/4 cup 4.5% cottage cheese
2 medium Sardines
* Limit to 1-2 times per week
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Medium Fat Proteins

Choices have 75 calories and 5 grams of fat per serving.
One serving equals:

1 ounce Beef (any prime cut), corned beef, ground beef **
1 ounce Pork chop
1 each Whole egg (medium) **
1 ounce Mozzarella cheese
1/4 cup Ricotta cheese
4 ounces Tofu (note this is a Heart Healthy choice)
** choose these very infrequently


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Starches

Contain 15 grams of carbohydrate and 80 calories per serving.
One serving equals:

1 slice Bread (white, pumpernickel, whole wheat, rye)
2 slice Reduced calorie or "lite" Bread
1/4 (1 Ounce) Bagel (varies)
1/2 English muffin
1/2 Hamburger bun
3/4 cup Cold cereal
1/3 cup Rice, brown or white- cooked
1/3 cup Barley or couscous- cooked
1/3 cup Legumes (dried beans, peas or lentils)- cooked
1/2 cup Pasta- cooked
1/2 cup Bulgar- cooked
1/2 cup Corn, sweet potato or green peas
3 ounce Baked sweet or white potato
3/4 ounce Pretzels
3 cups Popcorn, hot air popped or microwave (80% light)


Fats

Contain 45 calories and 5 grams of fat per serving.
One serving equals:

1 teaspoon Oil (vegetable, corn, canola, olive, etc.)
1 teaspoon Butter
1 teaspoon Stick margarine
1 teaspoon Mayonnaise
1 Tablespoon Reduced fat margarine or mayonnaise
1 Tablespoon Salad dressing
1 Tablespoon Cream cheese
2-Tablespoons Lite cream cheese
1/8th Avocado
8 large Black olives
10 large Stuffed green olives
1 slice Bacon

National Heart, Lung and Blood Institute, based on American Dietetic Association Exchange List