Introduction

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Present by:Sajjad Moradi-Ms student

Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran

The Exchange List System

What is the Exchange SystemThe exchange system is the

basis of your meal plan.

Diabetes diet

Weight loss, CVD, Renal, HTN, hyperlipidemia, atherosclerosis ?

Introduction

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Introduction

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Excellent tool for:1. Meal planning2. Calorie control3. Meeting AMDRs and DRIs

Application of Exchange List System

Advantages

variety of healthful food choices

According to different age groups

allows individuals to be accountable for what they eat

Introduction

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.

More than one energy source gives us

Disadvantages

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 Possibility of measurement error

 Absorption rates vary in different individuals

Portion sizes are based on:

Grams of proteinGrams of carbohydrateGrams of fatTotal number of Calories

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To use the exchange system

Familiarize yourself with the different food groups and the amounts indicated in your meal plan.

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Standard measurement used in this present:

1 cup = 236 ml

1 tbsp = 14.8ml

1tsp = 4.2 ml

1 oz = 29.57 ml

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Introduction

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Whole grain products average about 2 grams of fiber per serving

A good source of B vitamins

Measurement units after cooking

Starch

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Starch

Taster One starch exchange 15 g carbohydrate3 g protein0 g fat80 caloriesIn general, 1 starch is:•½ cup of cooked cereal, grain, or starchy vegetable•½ cup of cooked rice or pasta•1 oz of a bread product, like 1 slice bread•¾ to 1 oz of most snack foods

Starch

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BreadsBagel ½ bagel = 1 exchangeBread – whole wheat 1 slice = 1 exchangeCereals & GrainsCooked cereal – oatmeal, cream of wheat ½ cup cooked = 1 exchangeDry Cereal (read box) ½ to ¾ cup = 1 exchangePasta ½ cup = 1 exchangeRice – white or brown ½ cup = 1 exchange

Starch

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Starchy VeggiesBaked beans/refried beans 1/3 to ½ cup = 1 exchangePeas ½ cup cooked = 1 exchangeCorn ½ cup cooked or 6 inch on cob = 1 exchangePotato/Yam/Sweet Potato ½ cup mashed

Crackers and SnacksPopcorn 3 cups = 1 exchangePotato chips/tortilla chips 10 chips = 1 exchangeRice Cakes – 4 in across 2 cakes = 1 exchangeWhole wheat crackers 2-5 crackers (3/4 oz) = 1 exchange

Starch

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Beans, Peas, and LentilsBeans and peas (garbanzo, pinto, kidney, white, split, black-eyed) 1/3 cup = 1 starch or 1 proteinLima beans 1/3 cup = 1 starch or 1 proteinLentils 1/2 cup = 1 starch or 1 protein

Starchy Foods Prepared with FatBiscuit – 2 ½ in across 1 biscuit = 1 starch plus 1 fat exchangeCrackers round butter type 6 crackers = 1 starch plus 1 fat exchangePopcorn, microwaved 3 cups = 1 starch plus 1 fat exchangeSandwich crackers – cheese or peanut butter filling

Fresh, frozen and dry fruits have fiber

Fruits

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high in vitamins and minerals

beta carotene ,vitamin C, and other antioxidants like lyco -pene

Fruits

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Typically, 1 fruit exchange is:•1 small (4 oz) fresh fruit•½ cup of fresh fruit or canned •½ cup unsweetened fruit juice•¼ cup of dried fruit

One fruit exchange =15 g carbohydrate0 g protein0 g fat60 calories

Vegetables contain 2-3 grams of dietary fiber

Vegetables

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high in vitamins and minerals

brightly color

Vegetables

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½ C Cooked vegetables (carrots, broccoli, zucchini, cabbage, etc.)

1 C Raw vegetables or salad greens½ C Vegetable juice

If you’re hungry, eat more fresh or steamed vegetables.

• 1 vegetable exchange =• 5 g carbohydrate• 2 g protein• 0 g fat• 25 calories

Dairy

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an excellent sourceof calcium.

saturated fat content

healthy bones and teeth,

reduce high blood pressure control weight.

Dairy

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1 Milk and Alternatives exchange =12 carbohydrate8 g protein0 to 8 g fat90 to 150 calories

Milk- skim or 1% 1 cup (8 oz) = 1 exchangeSoy milk – low fat or fat free 1 cup = 1 exchangeYogurt – fat free or light 2/3 cup (6 oz) = 1 exchange

Dairy

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cream cheeseFats group Meat group

Meat

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primary source of protein

Choose lean Meat Eat fish at least twice a week

Beans fiber source

Meat

Taster 1 Meat and Alternatives exchange = 0 g carbohydrate7 g protein3 to 8 g fat35 to 100 calories Poultry1 oz meat = 1 exchange FishAny fresh or frozen fish 2 oz = 1 exchangeCrab, lobster, scallops and shrimp 2 oz = 1 exchangeTuna ¼ cup = 1 exchange

Meat

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Beef1 oz meat = 1 exchange Cheese1 oz = 1 exchange OtherEgg w/yolk 1 egg = 1 exchangeHot dog 1 oz = 1 exchangePeanut Butter 1-2 Tbsp = 1 exchangeSausage 1 oz = 1 exchangeTofu ½ cup = 1 exchange

Fats

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vitamins (A, D, E, and K)

essential fatty acids

weight gain

increase in blood cholesterol levels

Fats

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One Fats exchange =0 g carbohydrate0 g protein5 g fat45 calorieTypically, 1 fat exchange is:1 tsp margarine or vegetable oil 1 Tbsp salad dressing 2 Tbsp reduced fat salad dressing

Fats

Taster Mono-unsaturated and Poly-unsaturated FatsAvocado, medium 2 TbspNuts – almonds mixed 6 nutsPeanuts 10 nutsPecans 4 halvesMargarine 1 tspSeeds – pumpkin, sunflower 1 TbspSaturated FatsBacon – 1 sliceButter – stick 1 tsp, whipped 2 tsp, reduced fat 1 TbspCream cheese – regular 1 Tbsp, reduced fat 1 ½ Tbsp

contain added sugar

Other foods

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contain added sugar low in vitamins, minerals,and fiber

high in calories1 Other Foods exchange =15 g carbohydrateVarying amount ofprotein, fat, and calories

Other foods

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Brownie, small, unfrosted 2” square (about 1 oz) = 1 carbohydrate, 1 fat

Cake, unfrosted 2” square (about 1 oz) = 1 carbohydrate, 1 fat

Cake, frosted 2” square (about 2 oz) = 2 carbohydrate, 1 fat

Sweets, Desserts & Other Carbohydrates

Combination Foods ListTuna noodle casserole, lasagna, spaghetti with

meatballs, chili with beans 1 cup (8 oz) = 2 carbohydrates, 2 proteins

Chicken or tuna salad ½ cup (3 ½ cup) = ½ carbohydrate, 2 proteins, 1 fat

Pizza, cheese, thin crust ¼ of 12 inch (6 oz) = 2 carbohydrates, 2 meats, 1 fat

Other foods

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Example

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Example

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Example

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Food pyramid and exchange listcompressionServing size

Type of Food Food Exchange pyramid

Vegetables 1/2 cup - 1 cup 1 cup -2 cups

Milk 1 cup 1 cup  

Cheese 30gr 45grMeat 1 oz 2 to 3 oz  

Fruits 1 piece, 1/2-1 cup 1 C or 1 medium sized-1/2 cup

Starches 3ogr- ½ cup 3ogr- ½ cupRice ½ cup 1/3cup

Fats 1 tsp, 1-2 tbls. 1 tsp, 1-2 tbls.

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compression

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fats Separated group ---------Nuts fats meat

Beans Meat & starch meatCheese Meat Dairy

Corn, green peas and potatoes

starch vegetable

Olives and avocados fats vegetableBacon fats Meat

food Exchange pyramidCarbohydrate , protein

and fatProtein , minerals and vitamins

Calculate calories Provide RDA recommendationsMeal planning Basic guide

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Combining Food Guide Pyramid Plan with the Exchange Lists

Helps choose foods that provide all nutrients Promotes adequacy, balance and variety Exchange system uses calorie control and moderation

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ResourcesAmerican Association of Diabetes Educatorswww.diabeteseducator.org

American Diabetes Associationwww.diabetes.org

Academy of Nutrition and Dieteticswww.eatright.org

The Official Pocket Guide to Diabetic Exchanges American Diabetes Association, 2011

Resourceshttp://www.lillydiabetes.com/documents/pdf/

LD90772_DailyMealPlanGuide.pdf http://www.diet.com/g/exchange-systemhttp://fnic.nal.usda.gov/diet-and-disease/diabetes/carbohydrate-

counting-and-exchange-listshttp://www.nhlbi.nih.gov/health/educational/lose_wt/eat/

fd_exch.htmhttp://www.pamf.org/southasian/healthy/nutrition/

pyramidservingcharts.html