Nutrition hmw
Lisa
diabetic_exchange.pptxDiabetic Exchange System Overview
FN255
What is it?
A system that allows one to quickly estimate intake or plan a diet
Estimate carbohydrate, fat, protein, or kcals
An exchange is a specific amount of a food inside a food group category
All exchanges in each group provide the same amounts
Serving size varies
Why use it?
Can be challenging to memorize the exchanges and amounts per exchange
Once you are familiar, you can quickly estimate amounts
Writing recommendations or analyzing intake
Handy when an electronic database or list is not available
How to use it
Exchange groups
Starch
Milk
Whole, Reduced fat, Skim
Fruits
Vegetables
Meats
Very lean, lean, medium fat, high fat
Fats
How to Use it
Determine how many exchanges are provided by a specific food/meal.
Multiply the number of exchanges x kcals, CHO, Pro, and Fat per exchange.
Total amounts for the day.
Exchanges
| Group | g CHO | g FAT | g PRO | Kcals |
| Starch | 15 | 0-1 | 1-3 | 80 |
| Fat-Free Milk | 12 | 0 | 8 | 90 |
| Low-Fat Milk | 12 | 5 | 8 | 120 |
| Whole Milk | 12 | 8 | 8 | 150 |
| Fruit | 15 | 0 | 0 | 60 |
| Vegetables | 5 | 0 | 2 | 25 |
| Very Lean Protein | 0 | 0-1 | 7 | 35 |
| Lean Protein | 0 | 3 | 7 | 55 |
| Med-fat Protein | 0 | 5 | 7 | 75 |
| High-fat Protein | 0 | 8 | 7 | 100 |
| Fat | 0 | 5 | 0 | 45 |
Starch
One exchange = 1 oz equivalent
80 kcals, 15 g CHO, 3 g Pro, 1 g Fat
Includes grains and starchy vegetables
Potatoes, corn, sweet peas
X 1: slice of bread, 2.5” biscuit, 2x2” cornbread, small muffin, 4” waffle, sm potato
½ cup: pasta, hot cereal, corn, potatoes, bran cereal, shredded wheat
¾ cup: dry cereal
1/3 cup: cooked rice, beans* and peas
Milk
Skim: 90 kcals, 12 g CHO, 8 g Pro, 0 g fat
1 cup slim milk, ½ - 1% milk, low-fat buttermilk, 8 oz low or non-fat yogurt
Low-fat: 120 kcals, 12 g CHO, 8 g Pro, 5 g fat
2 % milk, plain low-fat yogurt
Whole: 150 kcals, 12 g CHO, 8 g PRO, 8 g fat
1 cup: whole milk, ½ cup: evaporated whole milk, 8 oz: whole milk plain yogurt
Fruit
One exchange = 60 kcals, 15 g CHO, 0 g P, 0 g F
X1: medium apple, orange, pear, peach
X2: plums, tangerines, figs
½ cup: most cut fresh fruit, fruit juice
¼ cup: dried fruit
Other exchanges: 15 grapes, 1 - 1 ¼ cup melon
Berries: 1 ¼ c Straw, 1 c Rasp, ¾ c Blue & Black
Banana: x 1 small, x ½ large
Vegetables
Non-starchy
One exchange: 25 kcals, 5 g CHO, 2 g P, 0 g F
One exchange =
½ cup: cooked vegetables, vegetable juice
1 cup: raw vegetables
Remember starchy vegetables are starch equivalents: potatoes, corn, peas
Meats
1 oz equivalent for all, Fat and kcals vary
Very Lean: 35 kcals, 0 g C, 7 g P, 0-1 g F
Egg white (x3), fat-free lunch meat,
Lean: 55 kcals, 0 g C, 7 g P, 3 g F
Lean beef, pork, skinless poultry, lowfat lunch meat, seafood, fish, fish canned in water
Medium Fat: 75 kcals, 0 g C, 7 g P, 5 g F
Most beef, most pork, lamb, poultry with skin, lunch meat, fish canned in oil, white cheese, reduced fat cheese, tofu, whole egg (x1), organ meat
High Fat: 100 kcals, 0 g C, 7 g P, 8 g F
Beef (Prime cuts, ribs, corned beef, ground), Pork ribs, ground pork, sausage (x1 link or patty), fried fish, bologna, salami, sausage, peanut butter (1 T), hot dog (1 HFM+F)
Fats
One fat exchange = 45 kcals, 0 g CHO, 0 g pro, 5 g fat
1 tsp: Pure fats (oil, butter, margarine), Mayonnaise
1 Tbsp: Most Nuts, Reg Dressings, Red. fat mayo, Cream cheese
2 Tbsp: Red. Fat dressings, Sour cream
Olives: x10 sm, x5 lg
Avocado: 1/8 or ~1/4 c
Combinations & Desserts
1 cup casserole = 2 MFM, 2 S, 1 Fat
¼ Cheese Pizza = 1 MFM, 2 S, 1 Fat
1 cup chili w/ beans = 2 MFM, 2 S, 2 Fat
1 cup Mac & Cheese = 1 MFM, 2 S, 2 Fat
1 cup Spaghetti & MBs = 1 MFM, 2 S, 1 Fat
1 cup (most) Chunky soup = 1 MFM, 1 S, 1 V
1 cup Beans (cooked) = 1 LM, 2 S
2 small Cookies = 2 S, 1 Fat
½ cup Ice cream = 1 S, 2 Fat
1 oz chips = 1 s, 2 Fat
4 oz Soda, juice, lemonade, etc = 1 Fr
Extensive List
http:// www.glycemic.com/DiabeticExchange/The%20Diabetic%20Exchange%20List.pdf
This PDF document provides a more detailed look at the actual exchange sizes.
