Improve your health by learning
Diabetes- Nutrition
Diabetes Blog
< Go back

Take Control of Your Meals: Carbohydrate Counting and the Exchange List System

Nina Ghamrawi, MS, RD, CDE
November 10, 2022
March 6, 2023

The Exchange List System is a way of estimating the amount of carbohydrate, protein, and fat in different foods using a system that standardizes measurements of foods and gives you food group lists.

These lists divide carbohydrates, fruit, dairy, proteins, and fats and translates them into portion sizes with all the same amount of macronutrients in grams. For example, each carbohydrates, fruit, and dairy exchange have 15 grams of carbohydrate, one protein exchange will have 6-7g protein, and foods containing fat will be listed with the portion sizes that equates to 5g fat.

Carbohydrate Counting

Carbohydrate counting involves planning meals based on the total number of grams of carbohydrates you eat for that meal. You must be willing to keep track of the foods you eat and the carbohydrates you’ve been allowed. Reading and understanding food labels is very important and can help you manage this process. The more advanced your plan or journal is will make a big difference. If you keep a journal with the foods you eat, amount and how you feel throughout the day, it can help your dietitian make even more informed choices and give you the best advice possible. You can also upload food pictures to UnifiedCare app to keep track of what you are eating.

How do we use these tools?

Exchanges are not total food weight – ie. a slice of bread can weigh 40 grams but only be 15 grams of carbohydrate (one exchange). Different carbohydrates can be ‘exchanged’ for one another, so you will never be stuck eating the same things at each meal, you can simply use this list to swap out some or all of one food group for another.  

If your Diabetes Educator tells you that you need 3 carbs with each meal, you can choose 3 servings of any foods in the below graphic, because each carbohydrate serving below is equal to 15 grams, or 1 serving.

Examples of 1 Carbohydrate Exchange= 15 grams carbohydrate, 60-80 calories

Examples of 1 Lean Protein Exchange= 7 grams protein, 35-40 calories, 1g fat

  • 1 oz Turkey breast or chicken breast, skin removed
  • 1 oz Fish fillet (flounder, sole, tilapia, cod, etc.)
  • 1 oz Canned tuna in water
  • 1 oz Shellfish (clams, lobster, scallop, shrimp)
  • 3/4 cup Cottage cheese, nonfat or low-fat
  • 2 Egg whites
  • 1/4 cup Egg substitute
  • 1 oz Fat-free cheese
  • 1/2 cup beans, cooked (black beans, kidney, chickpeas, or lentils)** These count as 1 grain and 1 very lean protein

Examples of 1 Fat Exchange = 5 grams fat, 45 calories

  • 1 tsp Oil (vegetable, corn, canola, olive, etc.)
  • 1 tsp Butter
  • 1 tsp Stick margarine
  • 1 tsp Mayonnaise
  • 1 Tbsp Reduced-fat margarine or mayonnaise
  • 1 Tbsp Salad dressing
  • 1 Tbsp  Cream cheese
  • 2 Tbsp Lite cream cheese
  • 1/8 Avocado
  • 8 large Black olives
  • 10 large Stuffed green olives
  • 1 slice Bacon

Curious about other foods and their portion sizes in the exchange list system? Look here for more information. Talk to your dietitian to see how many exchanges of each food group you will need throughout the day.

We're here to support you.

Contact our call center at 1-866-899-3998. Mon-Fri, 6AM-5PM PST