Whether you like it or not, diabetes is sure to improve your math. If you are a diabetic then you will need to maintain a strict control over your diet if you do not want your blood sugar levels bouncing up and down like a yo-yo. This could prove to be very dangerous for your health. But, if eating the same dishes is causing you grief, then you can exchange some food items with others that have the same calorific content. This is called food exchange and here are tips on how to use food exchange for diabetics for best sugar control.
The method of calculating food exchange was devised by the American Diabetes Association and the American Dietetic Association. They divided foods into 3 distinct groups based on their carbohydrate content since controlling carbohydrate intake plays an important role in controlling diabetes. These groups are Fat Group, Meat and Meat Substitutes Group and Carbohydrate Group. These are also sub-divided into other foods groups such as vegetables, fruits, milk, etc. The food exchange program simply means that if 2 food products across food groups have the same carbohydrate content then they can be exchanged even if their fat and protein content or even calories vary, since carbohydrates have the maximum impact on blood level sugar.
You can now go through your food pyramid chart and seek out those items that have the same carbohydrate content. Studying this chart will also guide you when you buy food products from your local grocery store. For example, you can exchange a large 8 to 10 inch banana for 1 cup of fruit juice, provided you are allowed to have a serving of that size. If you are allowed a smaller serving then you can exchange a smaller banana for half a cup of fruit juice. Similarly, you can also exchange a large cup of cereal for two slices of bread. These calculations will also be useful when you eat at fast food restaurants since it will allow you to choose or exchange food products from the menus, which have an ideal level of carbohydrates. In fact, you can apply this formula for your diabetic cat or dog food or even for any other canin that you might have. Some reputed companies also make dry foods that have very low carbohydrate content and which can be safely fed to your diabetic dog or cat.
These calculations and exchanges will guide you towards a healthy diet that maintains your blood sugar levels along with offering a wide variety of healthy dishes. The list of food products that contain low carbohydrates and which can be safely exchanged is quite large and you should refer to health books or the Internet to guide you further. Many sites and books also carry a list of foods that should be avoided by diabetics and you should realize that you might have to pay for the cost of eating such items with your health.
When you use these charts to calculate food exchange for diabetics you will certainly be able to enlarge the number of dishes that you can safely eat and this will help convert your boring menu into an interesting, healthy and tasty one. On the other hand, your math too is sure to improve.
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The American Diabetes association and the American dietetic association has devised the method.
It categorizes foods into three groups based on carbohydrate content:
* Carbohydrate group
* Meat and meat substitute group
* Fat group
In addition, foods can be categorized into six groups based on their nutritional value:
* Meat and meat substitutes
Each exchange (serving) of food within a food group has roughly the same amount of carbohydrates. The amounts of protein, fat and calories can vary. Patients on special diets can use these food groups to swap foods within the same list knowing that each food will have roughly the same effect on their glucose level.
WHAT YOU SHOULD KNOW
If you have diabetes, your doctor may put you on a diabetic exchange diet to help control both your weight and the amount of sugar and cholesterol in your blood. You will need to measure your food while on this diet, and you will probably need to eat 3 meals and 1 to 3 snacks daily. This diet divides the foods you can eat into 6 groups and measures each food by exact serving size. That way you can be sure to eat the right amount from each food group daily.
WHAT YOU SHOULD DO
Your dietitian will give you a meal plan that lists the number of servings you may eat from each food group shown below. The plan will give examples of a typical selection from each group. You can exchange any food in a group for any other from the same group, always limiting yourself to the specified serving sizes. For example, 1 slice of bread can be exchanged for 3/4 cup dry cereal. Or you can exchange 1/2 cup fruit juice for 1/2 of a 9-inch banana. Ask your dietitian for the correct serving size if a food you want is not listed below. At first, weigh or measure all of your foods and beverages so that you eat only the specified amounts. Do not use sugar and avoid foods on the “Do Not Eat” list.
The word exchange refers to the fact that each item on a particular list in the portion listed may be interchanged with any other food item on the same list. An exchange can be explained as a substitution, choice, or serving. Each list is a group of measured or weighed foods of approximately the same nutritional value. Within each food list, one exchange is approximately equal to another in calories, carbohydrate, protein, and fat. To use the exchange lists, an individual needs an individualized meal plan that outlines the number of exchanges from each list for each meal and for snacks. The American Diabetes Association recommends that because of the complexity of nutrition issues, a registered dietitian, knowledgeable and skilled in implementing nutrition therapy into diabetes management and education, be the team member developing and implementing meal plans. The meal plan is developed in cooperation with the person with diabetes and is based on an assessment of eating changes that would assist the individual in achieving his or her target metabolic goals and of changes the individual is willing and able to make. Because of the accuracy and convenience of the exchange system, the exchange lists are used for weight management as well for diabetes management.
The exchange system categorizes foods into three main groups: Carbohydrates, Meat and Meat Substitutes, and Fats. Foods are further subdivided in these three groups into specific exchange lists. The Carbohydrate Group contains the Starch, Fruit, Milk, Sweets and desserts (other carbohydrates), and Vegetable lists. Foods from the Starch, Fruit, Milk, and Sweets lists can be interchanged in the meal plan, as they each contain foods with 60 to 90 calories and approximately 15 grams of carbohydrate. The Meat and Meat Substitute Group contains food sources of protein and fat. The group is divided into four lists: Very Lean Meats, Lean Meats, Medium-Fat Meats, and High-Fat Meats, allowing the user to see at a glance which meats are low-fat and which meats are high-fat. The lists have foods containing 35, 55, 75, and 100 calories, and 1, 3
, 5, and 8 grams of fat, respectively. The Fat Group contains three lists: Monounsaturated Fats, Polyunsaturated Fats, and Saturated Fats. Each food source contains an average of 45 calories and 5 grams of fat. The exchange lists also identify foods that contribute significant amounts of sodium. A sodium symbol is shown next to foods that contain 400 mg or more of sodium per exchange serving.
Advantages and Disadvantages
An advantage of the food exchange system is that it provides a system in which a wide selection of foods can be included, thereby offering variety and versatility to the person with diabetes. Other advantages of the lists are: (1) they provide a framework to group foods with similar carbohydrate, protein, fat, and calorie contents; (2) they emphasize important management concepts, such as carbohydrate amounts, fat modification, calorie control, and awareness of high-sodium foods; (3) by making food choices from each of the different lists a variety of healthful food choices can be assured; and (4) they provide a system that allows individuals to be accountable for what they eat. Furthermore, with an understanding of the nutrient composition of the exchange lists, nutrient values from food labels can be used and a wider variety of foods can be incorporated accurately into a meal plan.
Helpful Hints for Using the Exchange Lists
* Cereals, grains, pasta, breads, crackers, snacks, starchy vegetables, and cooked beans, peas, and lentils are on the starch list. In general, one starch exchange is ½ cup cereal, grain, or starchy vegetable; one ounce of a bread product, such as one slice of bread; one-third cup rice or pasta; or three-fourths to one ounce of most snack foods.
* Fresh, frozen, canned, and dried fruits and fruit juices are on the fruit list. In general, one fruit exchange is: one small to medium fresh fruit, one-half cup of canned or fresh fruit or fruit juice, or one-fourth cup of dried fruit.
* Different types of milk and milk products, such as yogurt, are on the milk list. One cup (eight fluid ounces) or two-thirds cup (six ounces) of fat-free or low-fat flavored yogurt sweetened with a non-nutritive sweetener are examples of one exchange.
* Vegetables are included in the Carbohydrate Group and are important components of a healthful diet. However, since three servings of vegetables are the equivalent of one carbohydrate serving, one or two servings per meal need not be counted. This was done to encourage consumption of vegetables and to simplify meal planning.
* Meat and meat substitutes that contain both protein and fat are on the meat list. In general, one exchange is: one ounce meat, fish, poultry, or cheese; or one-half cup beans, peas, lentils.
* In general, one fat exchange is: one teaspoon of regular margarine, mayonnaise, or vegetable oil; one tablespoon of regular salad dressings or reduced-fat mayonnaise; or two tablespoons of reduced-fat salad dressings.
* •A free food is any food or drink that contains less than 20 calories or less than five grams of carbohydrate per serving. Foods with approximately 20 calories should be limited to three servings per day and spread throughout the day.
* Some foods are in one list, but they may fit just as appropriately in another list. For example, foods in the Starch, Fruit, and Milk lists of the Carbohydrate Group each contribute similar amounts of carbohydrates and calories and may be interchanged. If fruits or starches are regularly substituted for milk, calcium intake may be decreased. Conversely, regularly choosing milk instead of fruits or starches may result in inadequate fiber intake. Foods from the Other Carbohydrate list of the Carbohydrate Group, the Combination Foods list, and the fast foods list are also interchangeable with the Starch, Fruit, and Milk lists. However, most of the dessert-type foods on the Other Carbohydrate list are higher in sugars and fat and need to be eaten within the context of a healthful meal plan.
* Beans, peas, and lentils are included in the Starch list of the Carbohydrate Group. The serving size (usually one-half cup) is counted as one starch and one very lean meat for vegetarian meal planning. If individuals are not practicing vegetarians, or use these foods less frequently and often as side dishes rather than main dishes, the very lean meat exchange does not need to be counted—one-half cup is equivalent to one starch.
* Skim and reduced-fat milks are recommended for adults and children over two years of age, rather than whole milk.
* Meat choices from the Very Lean or Lean Meat lists are encouraged. However, it is not necessary to add or subtract fat exchanges when using meat lists that differ from those ordinarily consumed.
* Whenever possible, monounsaturated or polyunsaturated fats should be substituted for saturated fats.
The exchange lists are updated periodically and a database is kept of the macronutrient composition of each food, thus assuring the accuracy of the lists. For health professionals, the macronutrient and calorie values of the exchange lists provide a useful and efficient tool for evaluating food records and for assessing nutrition adequacy.
Despite the many advantages the exchange lists offer, they may not be the most appropriate meal-planning tool for many persons. For instance, they are not appropriate for those who cannot understand the concept of “exchanging” foods. Because the exchange booklets are written at a ninth- to tenth-grade reading level, individuals must be able to either read at this level or understand the concept of exchanging foods. For an individual to use them effectively, several educational sessions, and practice, may be required.