1. SEPTEMBER 30, 2011 BRENDA RIOJAS, NUTRITIONIST EXCHANGE LIST MADE SIMPLE

2. WHY USE THE EXCHANGE? They are grouped together based on their similarities (Carbohydrates, Protein and Fats) Carbohydrates are the largest group we eat and they affect diabetics the most. Many foods in this group have starch or sugar or will convert into Glucose Protein are the second largest food group such as: meats and meat substitutes. Many contain fat whether it is lean, medium or high fat Fats are fats whether they are animal or vegetable, saturated or unsaturated or trans fat

3. DIABETES AND GRAMS Grams are easy to understand because they are the actual weight of what you are eating A serving of a Carbohydrate will have 15 grams. Calories will vary based on type of carbohydrate A serving of a Protein will have 7 grams. Calories will vary based on the type of protein (plant-based, lean, medium or high fat meat) A serving of Fat will have 5 grams. Fat will vary based on type of fat

4. GRAMS VS CALORIES The exchange is based in grams Grams is a unit of weight that is use in the food labels and packaging Calorie is a unit representing the energy provided by food as the body breaks it down Food Labels are Based on 2,000 calorie diet. (male average 2000 and women average 1500)

5. NUTRIENTS in THE EXCHANGE LIST Each group has the same average nutrient, grams and caloric value Carbohydrates ~ average 100 calories and 15 grams per serving Proteins ~ average 67 calories and 7 grams per serving Fats ~45 calories and 5 grams per serving

6. HOW THE EXCHANGE LIST IS USED There are 6 groups of the diabetic Exchange List: Starches Fruits Non-starchy vegetables Milk Meat and Meat substitutes Fats

7. Starches EXCHANGES (1) One serving (exchange) of a starchy food contains about 15 grams of carbohydrate 3 grams of protein 1 gram of fat 80 calories and one carbohydrate exchange. Choose whole-grain and low- fat starches.

8. Fruits EXCHANGES (2) One serving (exchange) of fruit contains about 15 grams of carbohydrate No protein or fat 60 calories Example: 1 small piece of fruit= 1 Carb choice (15 g ) and 60 calories

9. Meat and meat substitutes One serving (exchange) of meat or meat substitute contains about 7 grams of protein Lean meat. One serving contains 0 to 3 grams of fat and 45 calories Medium-fat meat. One serving contains 4 to 7 grams of fat and 75 calories High-fat meat. One serving contains 8 or more grams of fat and 100 calories EXCHANGES (3)

10. Milk and Yogurt EXCHANGES (4) One serving (exchange) of milk or yogurt contains about 12 grams of carbohydrate 8 grams of protein Fat-free or low-fat milk and yogurt products. One serving contains 0 to 3 grams of fat and 100 calories Reduced-fat milk and yogurt products. One serving contains 5 grams of fat and 120 calories Whole milk and yogurt products. One serving contains 8 grams of fat and 160 calories

11. Fats EXCHANGES (5) Unsaturated fats — including monounsaturated fats and polyunsaturated fats. Saturated fats and trans fats can increase your risk of heart disease. Fat= 5 grams of fat and 45 calories

12. Non-starchy Vegetables One serving (exchange) of a non-starchy vegetable usually contains 5 grams of carbohydrate 2 grams of protein No fat and only 25 calories 1 1/2 cups or more of cooked vegetables or 3 cups or more of raw vegetables in a meal, count them as one carbohydrate exchange EXCHANGES (6)

13. Sweets, desserts and other carbohydrates Eat sweets and desserts as part of your meal. Don't overdo it. Eat sugar-free or low-carb candy with caution. EXCHANGES (7)

14. FOOD LABELS

15. CARBOHYDRATE COUNTING It is more accurate because it counts the total number of carbohydrate grams One Carbohydrate serving is 15 grams For women a typical meal is 45-60 grams and a snack is 15-30 grams For men a typical meal is 60-75 grams and a snack is 15-30 grams

16. EXAMPLE OF CARB. COUNTING ONE INDIAN TACO. 1 ¼ of inch thick Fry bread 3 Carbs=45 g (6” across) 1-2 oz of meat 1 Prot=7g ½ Fat=2.5g ½ c Beans 1Carb & 1 Prot. 15 g & 3 g 1 oz of cheese 1 Prot.= 3g ½ Fat = 2.5g

17. EXAMPLE OF CARB. COUNTING RICE AND GRAVY 1/3 cup of Rice 1 Carb. = 15 grams 2/3 cup of Rice 2 Carb. = 30 grams 1 cup of Rice 3 Carb. = 45 grams Gravy 2 Tablespoons = 1 Fat = 5grams 4 Tablespoons = 2 Fat =10grams

18. PROTEIN Protein are divided based on the fat content Proteins will be 7 grams, the fats will be 3 grams for lean, 5 grams for medium and 8 grams for high Based on the American Heart Association, Protein servings per day should be 4-6 oz per day = 32-48 grams per day

19. FATS The Daily recommendations of Saturated fats is 7% of the total daily intake and Trans fats should be 0% Daily recommendation for cholesterol is 300 mg per day Do not forget FAT IS FAT WHETHER IS ANIMAL OF VEGETABLE

20. FIBER Daily recommendation is 25-30 grams of fiber Fiber is worth mentioning because it is indigestible yet beneficial to the digestive system Example: ½ c of boiled beans, peas or lentils have 3 grams of fiber. That is 10% of the total fiber or 1/10 of the total daily serving

21. FACTS ABOUT THE EXCHANGE LIST The exchange lists provides a lot of foods choices It will provide a variety in your meals Fruits, Starchy vegetables, meats, chicken, peanut butter, whole grain bread, vegetables, cheese, etc Following the grams = counting Carbs, protein and fats is easier for a diabetic than following calories Correct exchange plan will automatically give the correct calories

22. CONCLUSION There are 15 grams in one Carb which is equal to one serving One serving can be a slice of bread, a 1/3 c of rice or pasta, one 6” tortilla There are 7 grams in one Protein serving which is equal to one serving One serving is 1 oz of meat, ½ c of beans, 1oz cheese, 1 boiled egg

23. QUESTIONS????

24. RESOURCES American Dietetic Association @ www.eatright.orgwww.eatright.org American Diabetes Association @ www.diabetes.org/homepage www.diabetes.org/homepage American Heart Association @ www.americanheart.orgwww.americanheart.org