Food exchange list: what is it?

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A food exchange list is a system for determining a daily meal plan based on units or exchanges of various types of food. The nutrient content of each item listed is calculated based on its serving size, so items in the same category have approximately the same nutritional value. A serving size of one food in one category can be exchanged for a serving size of any other food in the same category, which is why a serving is called an exchange.

One of the earliest and most widely adopted exchange systems is the diabetic food exchange list, but the method is used in several popular diet plans. The United States Department of Agriculture Food Guide Pyramid (now MyPyramid) is an exchange system. Many countries in the European Union also recommend exchange-based food pyramids. Exchange systems can be adjusted for different calorie levels, typically between 1,200 and 2,000 calories, so they easily accommodate different diets.

On a typical diabetes exchange list, categories include meat and meat alternates, starches, fruits, vegetables, dairy, and fats. Other diets may have different category names, and may include different items, such as a category of foods that should be eaten in moderation or infrequently. Some foods may fall into more than one category, or be in a different category on one food exchange list than another. For example, beans are protein or meat swaps on some programs, but are in a separate category for beans and legumes on other programs. Cheese is classified as a meat substitute on the diabetic food exchange list, but as a dairy exchange on other plans.

Meat swaps can be beef, poultry, or fish, usually in one-ounce servings. They could also include non-meat protein sources, such as beans or peanut butter. In the diabetic exchange system, meat is further broken down by the amount of fat it contains, and higher fat sources are eaten less frequently.

Carbohydrate or starch exchanges generally include grains, breads, cereals, and starchy vegetables like potatoes. On some exchange lists, carbohydrates may be divided into more than one category. Grains, cereals, and pasta are often combined into one category of exchange, which may or may not include bread.

The serving size for a vegetable swap is usually about 0.5 cups (125 ml) for cooked vegetables or 1 cup (250 ml) for raw vegetables. Fruit swaps are often smaller than what most people in the United States consider to be a serving: Half a medium banana, for example, is a serving. Most plans call for a generous amount of fruit and vegetable swaps, as they tend to be low in calories.

The exchange systems are flexible and easy for most people to follow. The key to following an exchange system is to watch your serving sizes and not exceed the recommended number of exchanges. Anyone can follow an exchange system, but diabetics should consult with a dietitian, preferably one who specializes in diabetes, to find the best exchange list for their needs.

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