Dietary Requirements
Healthy eating is the first step in taking care of your diabetes.  You can make the difference in your blood glucose control through your food choices.  You do not need special foods.  In fact, the foods that are good for you are god for everyone.
It is important to eat about the same amount of food at the same times each day.  Regardless of what your blood glucose level is, try not to skip meals.  Skipping meals and snacks may lead to large swings in blood glucose levels.
What are Exchange Lists?
Exchange lists are foods grouped together because they are alike.  Each serving of food has about same amount of carbohydrate, protein, fat, and calories.  That is why any food on a list can be "exchanged" or traded for any other food on the same list. 
Carbohydrates:  Starch and sugar in food are carbohydrates.  When you eat carbohydrates, they turn into glucose and travel in your bloodstream.  Insulin helps the glucose enter cells, where it can be used for energy or stored.  Eating the same amount of carbohydrates daily at meals and snacks can help control your blood glucose levels.
Protein:  Meat, poultry, fish, milk, other dairy products, eggs, beans, peas and lentils are proteins.  Some starches and vegetables also contain protein.  The body uses protein for growth, maintenance and energy.  Your body needs insulin to use the protein you eat.
Fat:  Fat is in margarine, butter, oils, salad dressings, nuts, seeds, milk, cheese, meat, fish, poultry, snack foods, ice cream and desserts.  There are 3 kinds of fats:  monounsaturated, polyunsaturated, and saturated.  Saturated fats can raise your blood levels of cholesterol.  Monounsaturated fats are the best choice but polyunsaturated fats are also good choices. 
Fats are used for energy and stored in the cells.  You need insulin to help store these fats.
Exchange Lists
Exchange lists are groups of foods that contain roughly the same mix of carbohydrates, protein, fat, and calories. There are six exchange lists:  1) Starches and Breads, 2) Meats and Meat Substitutes, 3) Vegetables, 4) Fruits, 5) Milk, and 6) Fats.
1) Starches and Breads
Choose your starch exchanges from this list. Each item is 1 exchange and contains about 80 calories.

CEREALS / GRAINS / PASTA
 

  •      Bran cereals, concentrated 1/3 Cup 
  •      Bran cereals, flaked ½ cup 
  •      (Bran Buds®, All Bran®) 
  •      Bulgur, cooked 2 cup 
  •      Cooked cereals 2 cup 
  •      Cornmeal, dry 1½ tbsp 
  •      Grapenuts 3 tbsp 
  •      Grits, cooked 2 cup 
  •      Pasta, cooked 2 cup 
  •      Rice (white or brown), cooked 2 cup 
  •      Shredded Wheat ½ cup 
  •      Unsweetened cereals ¾ Cup 
  •      Wheat germ 3 tbsp 
DRIED BEANS/PEAS/LENTILS
 
  •      Beans and peas, cooked 1/3 Cup (kidney, white, split, blackeye) 
  •      Lentils, cooked 1/3 Cup 
  •      Baked beans 1/4 Cup 
STARCHY VEGETABLES
 
  •      Corn 1/2 cup 
  •      Corn on cob, 6" 1 
  •      Lima beans 1/2 cup 
  •      Peas, green (canned or frozen) 1/2 cup 
  •      Plantain 1/2 cup 
  •      Potato, baked 1 small (3 oz) 
  •      Potato, mashed 1/2 cup 
  •      Squash, winter (acorn, butternut) 3/4 cup 
  •      Yam, sweet potato, plain 1/3 cup 
BREAD
 
  •      Bagel 1/2 (1 oz.) 
  •      Bread sticks, crisp, 4" x l/2'' 2 (2/3 oz.) 
  •      Croutons, low fat 1 Cup 
  •      English muffin 1/2 
  •      Frankfurter or hamburger bun 1/2 (1 oz.) 
  •      Pitta, 6" 1/2 
  •      Plain roll, small 1 (1 oz.) 
  •      Raisin bread, unfrosted 1 Slice (1 oz.) 
  •      Rye, pumpernickel 1 Slice (1 oz.) 
  •      Tortilla, 6" 1 
  •      White bread (including French or 1 Slice (1 oz.) Italian) 1 Slice (1 oz.) 
  •      Whole wheat bread 
CRACKERS/SNACKS
 
  •      Animal crackers 8 
  •      Graham crackers, 1.5" square 3 
  •      Matzo 3/4 oz. 
  •      Melba toast 5 slices 
  •      Oyster crackers 24 
  •      Popcorn (popped, no fat added) 3 cups 
  •      Pretzels 3/4 oz. 
  •      Rye crisp 2" x 3.5" 4 
  •      Saltine type crackers 6 
  •      Whole wheat crackers, no fat added 2-4 slices
STARCH FOODS PREPARED WITH FAT

(Count as 1 starch/bread serving, plus 1 fat serving) 
 

  •      Biscuit, 2.5 in. across 1 
  •      Chow mien noodles 1/2 cup 
  •      Corn Bread, 2 inch cube 1 (2 oz) 
  •      Cracker, round butter type 6 
  •      French fried potatoes, 2 to 3.5 inch 10 (1.5 oz) 
  •      Muffin, plain, small 1 
  •      Pancake, 4 inch 2 
  •      Stuffing, bread, (prepared) 1/4 cup 
  •      Taco shell, 6 inch 2 
  •      Waffle, 4.5 inch square 1 
  •      Whole wheat crackers, fat added (Triscuits) 4-6 (1oz) 
2) Meats and Meat Substitutes
Choose meat and meat substitute exchanges from the lean, medium-fat, and high-fat lists. Each item is 1 exchange (usually 1 ounce of meat) and contains from 3 to 8 grams of fat and from 55 to 100 calories. Include mostly lean and medium-fat meats, poultry, fish, and meat substitutes in your meal plan. 

LEAN MEAT AND MEAT SUBSTITUTES
 

  • Beef:  Lean 1 oz. beef: steaks (round, sirloin, or flank tenderloin, chipped beef 
  • Pork Lean pork: ham (fresh, canned, cured, 1 oz. or boiled), Canadian bacon, tenderloin 
  • Veal All cuts are lean, except for cutlets. Examples of lean veal include chops and roasts . 
  • Poultry Chicken, turkey, Cornish hen (without 1 oz. skin) 
  • Fish All fresh and frozen fish 1 oz. Crab, lobster, scallops, shrimp, clams 2 oz. Oysters 6 Tuna (canned in water) 1/4 cup Herring (uncreamed or smoked) 1 oz. Sardines (canned) 2 medium 
  • Game Venison, rabbit, squirrel, pheasant, 1 oz. duck goose (without skin) 
  • Cheese Any cottage cheese 1/2 Cup Grated parmesan 2 tbsp Diet cheeses (less than 55 calories per 1 oz.
  • Other 95% fat-free luncheon meat 1 oz. Egg whites 3 whites Egg substitutes (less than 55 calories 1/4 cup) 

 

MEDIUM-FAT MEAT AND MEAT SUBSTITUTES
 

  • Beef Most beef products: ground beef (all 1 oz. types), roast (rib, chuck, rump), steaks (cubed, Porterhouse, T-bone), meat loaf 
  • Pork Most pork products: chops, loin roast, 1 oz. Boston butt, cutlets 
  • Lamb Lamb: Most lamb products: chops, leg, 1 oz. roast 
  • Veal Veal: Cutlets (ground or cubed, unbreaded) 1 oz. 
  • Poultry Poultry: Chicken (with skin), domestic 1 oz. duck or goose 1 oz. (well-drained of fat), ground turkey 
  • Fish Tuna (canned in oil and drained), 1/4 Cup salmon (canned) 
  • Cheese Cheese: Skim or part-skim milk cheeses: Ricotta 1/4 Cup Mozzarella 1 oz. Diet cheeses (56-80 calories per oz.) 1 oz. 
  • Other 86% fat-free luncheon meat 
  • 1 oz. Eggs (high in cholesterol; limit to 3 per 1 week) 
  • 1/4 Cup Egg substitutes (56-80 calories per ¼ Cup) 4 oz. 
  • 1/ 1 oz. Tofu (2.5" x 2.75" x 1") 
  • Liver, heart, kidney, sweetbreads (all high in cholesterol)
HIGH-FAT MEAT AND MEAT SUBSTITUTES

(Use only 3 times per week) 

  • Beef Most USDA Prime cuts: ribs, corned beef 1 oz. 
  • Pork Spareribs, ground pork, pork sausage 1 oz. (patty or link) 
  • Lamb Patties (ground) 1 oz. 
  • Fish Fried fish (any kind) 1 oz. 
  • Cheese All regular cheeses: American, blue, cheddar, Monteray jack, Swiss 1 oz.
  • Other Luncheon meats: bologna, salami, pimento loaf 1 oz. 
  • Sausage (Polish, Italian, Bratwurst, Knockwurst)(smoked) 1 oz. 
  • Frankfurter (turkey or chicken, 10 per 1 tbsp pound) 
  • Bacon (3 slices) Counts as one high-fat meat plus one fat 
  • 1 Peanut butter (contains unsaturated fat) Counts as one high-fat meat plus one fat 
3) Vegetables
Choose vegetable exchanges from this list. Unless otherwise noted, serving size is ½ cup for cooked vegetables and vegetable juices or 1 cup for raw vegetables. A serving of any item is one exchange and contains about 25 calories and 2-3 grams of dietary fiber.
 
  •      Artichoke (1/2 medium) 
  •      Asparagus 
  •      Beans (green, wax, Italian) 
  •      Bean sprouts 
  •      Beets 
  •      Broccoli 
  •      Brussels sprouts 
  •      Cabbage (cooked) 
  •      Cauliflower 
  •      Eggplant 
  •      Greens (collard, mustard, turnip) 
  •      Kohlrabi 
  •      Leeks 
  •      Mushrooms (cooked) 
  •      Okra 
  •      Onions 
  •      Pea pods 
  •      Peppers (green) 
  •      Rutabaga 
  •      Sauerkraut 
  •      Spinach (cooked) 
  •      Summer squash (crookneck) 
  •      Tomato (one large) 
  •      Tomato/vegetable juice 
  •      Turnips 
  •      Water chestnuts 
  •      Zucchini (cooked) 
4) Fruits
Choose fruit exchanges from this list. Each item is one exchange and contains about 60 calories. 

FRESH, FROZEN, AND UNSWEETENED CANNED FRUIT
 

  •      Apple (raw, 2" diameter)             1 apple 
  •      Applesauce (unsweetened)             ½ cup 
  •      Apricot (medium, raw)                4 apricots 
  •      Apricot (canned)                     halves 
  •      Banana (9" long)                     ½ banana 
  •      Blackberries (raw)                   3/4 Cup 
  •      Blueberries (raw)                    3/4 Cup 
  •      Cantaloupe (5" diameter)             1/3 melon 
  •      Cantaloupe (cubes)                   1 cup 
  •      Cherries (large, raw)                12 cherries 
  •      Cherries (canned)                    ½ cup 
  •      Figs (2", raw)                       2 figs 
  •      Fruit cocktail (canned)              ½ cup 
  •      Grapefruit (medium)                  ½ grapefruit 
  •      Grapefruit (segments)                ¾ Cup 
  •      Grapes (small)                       15 grapes 
  •      Honeydew (medium                     1/8 melon 
  •      Honeydew (cubes)                     1 Cup 
  •      Kiwi (large)                         1 kiwi 
  •      Mandarin oranges                     ¾ Cup 
  •      Mango (small)                        ½ mango 
  •      Nectarine (1.5" diameter)            1 nectarine 
  •      Orange (2.5" diameter)               1 orange 
  •      Papaya                               1 Cup 
  •      Peach (2.75" diameter)               1 peach or ¾ Cup 
  •      Peaches (canned)                     2 halves or ½ cup 
  •      Pear                                 ½ large or 1 small 
  •      Pears (canned)                       2 halves or ½ cup 
  •      Persimmon (medium, native)           2 persimmons 
  •      Pineapple (raw)                      ¾ Cup 
  •      Pineapple (canned)                   1/3 Cup 
  •      Plum (raw, 2" diameter)              2 plums 
  •      Pomegranate                          ½ pomegranate 
  •      Raspberries (raw)                    1 Cup 
  •      Strawberries (raw, whole)            1 1/4 Cup 
  •      Tangerine (2.5" diameter)            2 tangerines 
  •      Watermelon (cubes                    l l/4 cup 
     DRIED FRUIT 
  •      Apples     4 rings 
  •      Apricots   7 halves
  •      Dates      2½ medium 
  •      Figs       1 ½
  •      Prunes     3 medium 
  •      Raisins    2 tbsp 
     FRUIT JUICE
 
  •      Apple juice/cider  ½ Cup 
  •      Cranberry juice cocktail  1/3 Cup
  •      Grapefruit juice   ½ Cup 
  •      Grape juice        1/3 Cup
  •      Orange juice       ½ Cup 
  •      Pineapple juice   ½ Cup
  •      Prune juice        1/3 Cup 
5) Milk
Choose milk exchanges from the skim and very low-fat, low-fat, and whole-milk lists. Each item is one exchange and contains trace amounts to 8 grams of fat and from 90 to 150 calories.

SKIM AND VERY LOW-FAT MILK
 

  •      Skim milk, ½% milk, 1% milk, low-fat buttermilk   1 cup
  •      Evaporated skim milk                              ½ cup
  •      Dry non-fat milk                                  1/3 Cup
  •      Plain non-fat yogurt                              8 oz.
LOW-FAT MILK
 
  •      2% Milk      1 Cup 
  •      Plain low-fat yogurt (with added 8 oz. non-fat milk solids) 
WHOLE MILK
 
  •      Whole milk              1 Cup
  •      Evaporated whole milk   ½ oz.
  •      Whole plain yogurt      8 oz. 
6) Fats
Choose fat exchanges from these lists. Each item is 1 exchange and contains about 45 calories.

UNSATURATED FATS

Avocado 1/8 medium Margarine 1 tsp Margarine, diet 1 tbsp Mayonnaise 1 tsp Mayonnaise, reduced calorie 1 tbsp Nuts and seeds: Almonds (dry roasted) 6 whole Cashews (dry roasted) 1 tbsp Pecans 2 whole Peanuts 20 sm or 10 lrg Walnuts 2 whole Other nuts 1 tbsp Seeds, pine nuts, sunflower (no 1 tbsp shells) 2 tbsp Pumpkin seeds 1 tsp Oil (corn, cottonseed, safflower, soybean, sunflower, olive, peanut) Olives 10 small or 5 large Salad dressing, mayonnaise-type 2 tsp Salad dressing, mayonnaise-type, reduced-calorie 1 tbsp Salad dressing (all varieties) 1 tbsp Salad dressing, reduced-calorie 2 tbsp (Two tablespoons of low-calorie salad dressing is a free food.) 

SATURATED FATS

Butter 1 tsp Bacon 1 slice Chitterlings ½ oz. Coconut (shredded) 2 tbsp Coffee whitener, liquid 2 tbsp Coffee whitener, powder 4 tsp Cream (light, coffee, table) 2 tbsp Cream, sour 2 tbsp Cream (heavy, whipping) 1 tbsp Cream cheese 1 tbsp Salt pork ¼ oz. 
 

FREE FOODS 
Free foods are foods and drinks that have less than 20 calories per serving. When no serving size is specified, you can eat as much of the item as you want. You can eat 2 or 3 servings of those items that have specific serving sizes each day; be sure to spread them out through the day. 

DRINKS
 

  •           Bouillon or broth without fat 
  •           Bouillon, low sodium 
  •           Carbonated drinks, sugar-free 
  •           Carbonated water 
  •           Club soda 
  •           Cocoa powder, unsweetened (1 tbsp) 
  •           Coffee/Tea 
  •           Drink mixes, sugar-free 
  •           Tonic water, sugar-free 
     NONSTICK PAN SPRAY

     FRUIT
 

  •           Cranberries, unsweetened (1/2 cup) 
  •           Rhubarb, unsweetened (1/2 cup) 
     RAW VEGETABLES (1 CUP)
 
  •           Cabbage 
  •           Celery 
  •           Chinese cabbage 
  •           Cucumber 
  •           Green onion 
  •           Hot peppers 
  •           Mushrooms 
  •           Radishes 
  •           Zucchini
     SALAD GREENS
 
  •           Endive 
  •           Escarole 
  •           Lettuce 
  •           Romaine 
  •           Spinach
     SWEET SUBSTITUTES
 
  •           Candy, hard, sugar-free 
  •           Gelatin, sugar-free 
  •           Gum, sugar-free 
  •           Jam/Jelly sugar-free (1-2 tbsp) 
  •           Sugar substitutes: saccharin, aspartame 
  •           Whipped topping (2 tbsp)
     CONDIMENTS
 
  •           Catsup (1 tbsp) 
  •           Horseradish 
  •           Mustard 
  •           Pickles, dill, unsweetened 
  •           Salad dressing, low-calorie (2 tbsp) 
  •           Taco sauce (1 tbsp) 
  •           Vinegar
     SEASONINGS

Seasonings can be helpful in making food taste better. Check labels for sodium content, and choose seasonings that do not contain "sodium" or "salt." 
 

  •           Basil 
  •           Celery seed 
  •           Cinnamon 
  •           Chili powder 
  •           Chives 
  •           Curry 
  •           Dill 
  •           Flavoring extracts (vanilla, almond, walnut, peppermint, butter, lemon, etc.) 
  •           Garlic 
  •           Garlic powder 
  •           Herbs 
  •           Hot pepper sauce 
  •           Lemon 
  •           Lemon juice 
  •           Lime 
  •           Lime juice 
  •           Mint 
  •           Onion powder 
  •           Oregano 
  •           Paprika 
  •           Pepper 
  •           Pimento 
  •           Soy sauce 
  •           Soy sauce, low sodium ("lite") 
  •           Spices 
  •           Wine, for cooking (1/4 Cup) 
  •           Worcestershire sauce 
FOODS FOR OCCASIONAL USE 
The foods on this list can be included in your meal plan, despite their sugar or fat content, provided you maintain blood-glucose control. Average exchange values are listed for each item; because these foods are concentrated sources of carbohydrates, the serving are small.
 
SERVING  EXCHANGES 
  • Angel food cake 
  • Cake (no icing)
  • Cookies
  • Frozen fruit yogurt
  • Gingersnaps
  • Granola 
  • Granola bar 
  • Ice cream (any flavor)
  • Ice milk (any flavor) 
  • Sherbet (any flavor)
  • Snack chips (all varieties)
  • Vanilla wafers
  • 1/12 cake
    1/12 cake or  3" square
    2 small (1 3/4")
    1/3 Cup

    ¼ Cup 
    1 small 
    ½ cup
    ½ cup 
    ¼ cup
    1 oz. 
    6 small 
    2 starch
    2 starch, 2 fat
    2 starch, 2 fat 
    1 starch 
    1 starch 
    1 starch, 1 fat 
    1 starch, 1 fat
    1 starch, 2 fat 
    1 starch, 1 fat
    1 starch 
    2 starch, 2 fat
    1 starch, 1 fat 
     
    MANAGEMENT TIPS 
    Here are some tips to help you manage the way you eat: 
    • Make changes gradually. Don't try to do everything at once. It may take longer to accomplish your goals, but the changes you make will be permanent. 
    • Set realistic, short-term goals. If weight loss is your goal, try to lose two pounds in two weeks, not 20 pounds in one. Walk two blocks at first, not two miles. Success will come more easily, and you'll feel good about yourself! 
    • Reward yourself. When you achieve a short-term goal, treat yourself to a movie, buy a new shirt, read a good book, or visit a friend. 
    • Measure foods. Be careful about serving sizes, and learn to estimate the amount of food you are served when dining out. Measuring all the food you eat for a week or so will help you do this. Measure liquids with a measuring cup. Some solid foods (tuna cottage cheese, canned fruits) can be measured with a measuring cup, too. Use measuring spoons for smaller amounts of foods like oil, salad dressing, or peanut butter. You can use a scale to measure almost anything -- especially meat, poultry, and fish. 
    • Measure all foods after cooking. Some foods you buy uncooked will weigh less after you cook it. This is true of most meats. Starches often swell in cooking, so a small amount of uncooked starch can become a much larger amount of cooked food. 
    The following table illustrates these changes: 
     
    UNCOOKED COOKED
    STARCH FOODS 
    Oatmeal
    Cream of Wheat
    Grits
    Rice 
    Spaghetti 
    Noodles 
    Macaroni 
    Dried beans
    Dried peas 
    Lentils
    3 level tbsp
    2 level tbsp
    3 level tbsp
    3 level tbsp
    1/4 cup
    1/3 cup 
    1/4 cup
    3 tbsp
    3 tbsp
    2 tbsp 
    1/2 cup 
    1/2 cup
    1/2 cup 
    1/3 cup
    1/2 cup 
    1/2 cup
    1/2 cup 
    1/3 cup 
    1/3 cup 
    1/3 cup 
    MEATS 
    Hamburger
    Chicken
    Chicken
    4 oz.
    small drumstick 
    half breast 
    3 oz.
    1 oz.
    3 oz.
    • Read food labels. Remember dietetic does not mean diabetic! "Dietetic" on a food label means that something has been changed or replaced. There may be less salt, less fat, or less sugar, but dietetic food is not necessarily sugar-free or calorie-free. Some dietetic foods may be useful. You can eat dietetic foods that contain up to 20 calories per serving three times a day as free foods. 
    • Know your sweeteners. There are two types of sweeteners on the marker: those that contain calories and those that do not. Sweeteners with calories, such as fructose, sorbitol, and mannitol, can cause cramping and diarrhea when used in large amounts. And these sweeteners have calories, which do add up. Sweeteners without calories include saccharin and aspartame (Equal,® Nutrasweet®) and may be used in moderation. 
    More Helpful Hints
    Dietetic candy may satisfy your craving for sweets, but eat no more than 3 hard candies (usually 3 calories a piece) in a day. "Diet" chocolates contain many more calories in fat, Sorbitol, and milk solids. It is best to avoid these. 
    Here are a few more rules for keeping your insulin dependent diabetes in control:
    • If a meal is unavoidably delayed, you may need to prevent an insulin reaction with fast-acting sugar (see Chapter 9). You may also have to eat a small snack, such as 
    • If you are planning a late-evening dinner, eat your usual bedtime snack at your regular dinner hour. Then enjoy your late dinner. Do not have another bedtime snack. 
    • If you eat extra food, you'll need to adjust your activity level or insulin to accommodate the added blood glucose. 
    Eating Out 
    Sticking to your meal plan doesn't mean you can't eat out in restaurants or accept friends' dinner invitations.  But you do have to take precautions:
    • Keep your meal plan with you until you know it well. 
    • Order plainly cooked, familiar foods. Avoid casseroles, fried foods, cream soups, gravies, sauces, stuffings, breaded meats, and desserts. 
    • Try ordering ala carte. Ask the server about any food you're not familiar with. 
    • Measure foods at home so you'll be able estimate portions when you go out. Restaurant portions tend to be generous, so plan to share your meal or bring part of it home. 
    • Call ahead for information about menu offerings so you can plan your meal. This applies to both restaurants and friends. Don't be afraid to explain your meal plan requirements. People will usually cooperate. 
    • Never eat unacceptable foods to please your hostess or the cook. Your health is more important. 
    • Try to eat within an hour of your regular meal time. If there is a delay, ask for some crackers or bread sticks. 
    • Always carry some form of fast-acting sugar
    Sample Daily Meal Plan
    (2000 Calories)
    Meal Exchange Calories
    Breakfast 2 Starch 
    1 Meat 
    1 Fruit 
    1 Milk (Skim) 
    2 Fat 
    Total Calories
    160
     35
     60
     90
     90
    435 
    10 AM Snack 1 Starch OR 1 Fruit 60/80
    Lunch 3 Starch
    2 Meat
    1 Veg.
    1 Fruit
    1 Milk
    1 Fat
    Total Calories
    249
     70
     25
     60
     90
     45
    530
    2 PM Snack 1 Starch
    1 Fruit
    Total Calories
     80
     60
    140
    Supper 3 Starch
    2-3 Meats
    1 Veg.
    1 Fruit
    1 Milk
    1-2 Fat
    Total Calories
    240
    70/105
     25
     60
     90
    45/90 
    530/610
    HS Snack 2 Starch
    1 Meat
    Total Calories
    160
     35
    195
    Total Daily Calories 1890/1990
     
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