Does anyone remember the Exchange System? This is an approach to nutrition management for people with diabetes that was put together by the American Diabetes Association and the American Dietetic Association many moons ago. When I was diagnosed with type 1 diabetes in 1975, my parents were taught to use the Exchange System.
The Exchange System puts foods into one of six categories (exchanges) or the “free food” category. The six are starch, milk, fruit, vegetables, protein (meat) and fat. We were given a “diet” with a certain number of exchanges per meal. I like this approach, not because it prescribes a certain amount to eat, but because it emphasizes a well-balanced eating plan and because it emphasizes healthy portions. The “diet” part is now more of “guidelines” for healthy caloric intake.
Because every starch, milk and fruit exchange is equivalent to a “carbohydrate serving” (approximately 15 grams of carb), transitioning to carb counting was extremely easy for me. Having grown up with the Exchange System I know how many crackers, grapes, etc. equal an exchange. I know that 1/3 cup of cooked pasta or rice is an exchange or carb serving.
I have noticed that many people who go straight to carb counting run the risk of hyper-focusing on carbs. For instance, I have had people call me and ask how to account for the carb in peanut butter. If they knew the Exchange System, they would know that peanut butter is a fat and therefore, the carb content is negligible. Also, straight carb counting can lead to ignoring how much protein and/or fat is eaten. It’s important, however, not to overeat protein and fat in order to stay healthy in the long-run.
I give everyone I meet (professionally) a copy of the Exchange Lists for Diabetes booklet. If nothing else it’s a great starter list of foods and their serving sizes and carb content. I encourage carb counting for insulin dosing, as this is a very effective way to manage diabetes. I just think that basing carb counting on the Exchange System is a healthier and more successful approach.
Does anyone still use the Exchange System in any way, shape, or form?