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Food Swapping

By Megrette Fletcher, M.Ed., R.D., C.D.E

By Megrette Fletcher, M.Ed, RD, CDE

Co-author of Eat What You Love, Love What You Eat with Diabetes 

pastaSo, you want to add variety to your diet. How can you do this if you have diabetes? Consider using the concept of “food swapping.” Regardless of the method used – Point System, Carbohydrate Exchange or Guiding Stars – there are many different ways to learn if one food is nutritionally equivalent to another.

The method most often suggested for individuals with diabetes is the exchange system developed by the American Diabetes Association and the Academy of Nutrition and Dietetics Association.

The Exchange System

This system is a list of food groups:

  • Starch (carbohydrate-containing foods including starchy vegetables such as potatoes, corn, peas and orange squash, grains and beans)
  • Fruit
  • Dairy
  • Desserts
  • Non-starchy Vegetables (we describe these as low-carbohydrate vegetables)
  • Meat and Meat Substitutes
  • Fats
  • Combination Foods

These groups were determined by the specific macronutrient (carbohydrates, protein and fat) that they contain. The amount of food listed is the amount that offers the same amount of carbohydrates, or fat or protein as the above mentioned food groups.

People with diabetes are encouraged to learn more about carbohydrates. What often gets confusing is understanding “What is a carbohydrate ‘choice’?” This is the amount of food that offers 15 grams of carbohydrates per serving. The key is that the amount of food that equals 15 grams is not often the amount of food that you might eat. For example, a 15-gram carbohydrate portion of white rice is one-third cup. For most people, this amount of rice would not be considered a typical serving. Another example is that few people would eat half a banana at a meal. However, this amount of banana equals 15 grams of carbohydrates.

You might think, “That serving size is ridiculous!” You are not alone in this thought. However, the purpose of the exchange system isn’t to tell you how much to eat, it is to tell you the amount of food that equals 15 grams of carbohydrates.

The advantage of counting carbohydrates and the exchange system is you can learn how to swap out different foods and add variety to your diet. For example, you might think that instead of having a cup of rice for dinner (45 grams of carbohydrates), you would rather have a half cup of mashed potatoes (15 grams of carbohydrates), 8 ounces of milk (12-15 grams of carbohydrates) and a small dinner roll (15 grams of carbohydrates) for a total of 45 grams of carbohydrates. Understanding this concept of “food swapping” adds variety at a meal while keeping the total amount of carbohydrates consistent.

Need more help? To learn more about how to make a mindful food choice, read Chapter 9 of Eat What You Love, Love What You Eat with Diabetes.



About the author

Megrette Fletcher is a registered dietitian, certified diabetes educator, author, and co-founder of The Center for Mindful Eating. Megrette is the 2013-2014 president of The Center for Mindful Eating, a non-profit, organization to assist health professionals to explore the concepts of mindful eating. She has written articles for and has been quoted about mindful eating in Diabetes Self Management, Today’s Dietitian, Today’s Social Worker, Bariatric Times, Glamour, Family Circle, The Wall Street Journal, US News and World Report, Women’s Day, and Oxygen Magazine. Megrette currently works as a diabetes educator in Dover, New Hampshire.

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