Appendix B: The Exchange Lists for Meal Planning

📘 What Are the Exchange Lists?

The Exchange Lists for Meal Planning were first created in 1950 by the American Diabetes Association and the Academy of Nutrition and Dietetics. They were designed as a practical tool to help people—especially those with diabetes—estimate the nutrients in their meals. Foods are grouped into categories based on their similar amounts of carbohydrate (CHO), protein (PRO), and fat (FAT). This means one food can be “exchanged” for another in the same group without changing the overall nutrient balance.

For example, one slice of bread, ½ cup of corn, or ¼ cup of granola each counts as a single starch exchange—so you can swap between them while keeping your meal plan consistent.

Unlike the five groups in MyPlate, which categorize foods primarily based on their contributions to micronutrient (vitamins and minerals), the Exchange System focuses on macronutrient content. This makes it especially useful for individuals who need to closely track carbohydrates, protein, and fat, such as people with diabetes or on weight loss diets.

Each exchange within a group represents a standard portion size that contributes approximately the same amount of  CHO, PRO, and FAT and calories. For example:

• 1 starch exchange = 15g CHO, 3g PRO, 1g FAT

• 1 lean meat exchange = 7g PRO, 2g FAT

• 1 fruit exchange = 15g CHO

By learning these standard values, you can estimate the macronutrient and calorie content of a food or meal using these conversion factors:

• Carbohydrates = 4 kcal/g

• Protein = 4 kcal/g

• Fat = 9 kcal/g

📘 Is there a table for the Exchanges Lists?

The Exchange Lists are often shown in a table that outlines each food group, the calories provided, and standard serving size examples. This format makes it easy to compare foods within and across groups for practical meal planning.

Table B.1:  Exchange List with Macronutrients, Calories, and Examples

📘How do the serving sizes differ in the various exchange lists?

Serving sizes in the Exchange System are designed so that foods within each group provide similar amounts of carbohydrate, protein, fat, and calories. While the nutrient values are standardized, the actual portions look very different. Some examples for each exchange group are given below.

• Starch Exchange (Starchy Vegetables & Grains)

  • 1 slice of bread

  • ½ cup cooked pasta

  • ⅓ cup rice

  • ½ cup corn

  • ½ cup peas

• Fruit Exchange

  • 1 small apple

  • ½ banana

  • ½ cup orange juice

• Non-starchy Vegetable Exchange

  • 1 cup raw leafy vegetables

  • ½ cup cooked carrots

  • ½ cup broccoli

• Lean Meat/Protein Exchange (≈ 35 calories)

  • 1 ounce  baked  fish or  skinless poultry

  • 3 egg whites

• Medium Fat Meat/Protein Exchange (≈ 55 calories)

  • 1 ounce pork, lean cuts of beef, or fatty fish like salmon

  • 1 whole egg white

  • 1 oz mozzarella cheese (from part-skim milk)

• High-Fat Meat/Protein Exchange (≈ 100 calories)

  • 1 ounce sausage

  • 1 ounce bacon

  • 1 ounce cheddar or colby cheese

• Milk Exchanges

  • Fat-Free or Low-Fat (≈ 90 calories)

    • 1 cup skim or 1% milk

    • 6 ounces nonfat/light yogurt

  • Reduced-Fat (≈ 120 calories)

    • 1 cup 2% milk

    • 6 ounces reduced-fat yogurt

  • Whole Milk (≈ 150 calories)

    • 1 cup whole milk

    • 6 ounces whole-milk yogurt

• Fat Exchange (≈ 45 calories)

  • 1 teaspoon butter, oil, or mayonnaise

  • 2 teaspoons peanut butter

By distinguishing starchy vegetables (like corn and peas) from non-starchy vegetables (like carrots and broccoli) and including calorie ranges for milk and other groups, the Exchange System highlights both macronutrient balance and energy value, supporting consistent and flexible meal planning.

📘How does a typical meal fit into the Exchange System? 

Breaking down a common food, like a hamburger with lettuce, tomato, and cheese, shows how different components of one meal are divided into exchanges. This example helps illustrate how the system works in practice and makes it easier to see how everyday foods contribute carbohydrate, protein, fat, and calories.

🍔 Step 1: List the foods: Hamburger with Lettuce, Tomato, and Cheese

• 1 hamburger bun (top and bottom halves)

• 3 oz ground beef patty (85% lean)

• 1 slice cheese (regular)

• Lettuce leaf + 2 tomato slices

• 1 tsp mayonnaise or ketchup (optional condiment)

🍔  Step 2:  Complete the exchange group table.   Enter the food component, number of exchanges (portion), and the grams of CHO, PRO, and FAT, and Calories.

Table B.2:  Completed Exchange  List table for a cheeseburger

🍔 Step 3:  Total the grams of carbohydrate, protein, fat, and calories in the food.

Table B.3:  Total grams of carbohydrate, protein, and fat and calories in the cheeseburger

Using this method,  you can estimate nutrients without an app—just basic food knowledge and a copy of the Exchange List!