Diabetic exchange meal planning – not just for diabetes!

I’m gonna let you in on a little secret. If you’re seeing a nutritionist and they hand you a detailed meal plan telling you exactly what to eat for breakfast, lunch, and dinner; they’re probably not a Registered Dietitian. You see, rather than fostering dependence we prefer to teach the concepts of healthy eating that will allow for a lifetime of good nutrition. Trust me, there are enough people out there who need our services that we don’t have time to hold hands for the entire duration of your long and prosperous eating career.

The reason we don’t want to give you a meal plan, aside from the “give a man a fish/teach a man to fish” concept, is because we are not you. We don’t know all your food preferences, we don’t know how expert you are in the kitchen (or not). We certainly will learn some of this, but even three hours of chatting about your likes and dislikes will leave us with some questions. You’re the expert on you, so instead of assigning foods that you’re not going to like, we’d rather you apply our teachings and choose things that work for your lifestyle and preferences. Because honestly, it’s possible to fit almost any food into a good diet as long as you use responsible cooking techniques and don’t eat too much of it. If kale salads ain’t your thang than by golly I’m not going to force it on you. (And let’s all be real – raw kale kind of sucks)

The best way to provide a lot of daily structure while still allowing for personal food choice is by teaching the diabetic exchange diet. Contrary to what you might think, it’s not just for diabetes! Read on to find out why.

What are the Food Exchange Lists?

The exchange lists are a way of grouping similar foods together by type and defining a set quantity of each food to fit a standard for that type of food. If you scroll down in this document to page 3, you can see the beginning of the lists (I  have a more extensive word document that I send my patients, but you get the idea).  The exchange lists break all foods down into the following groups: Starch, meat (broken down by fatness), vegetable, fruit, milk (broken down by fatness) and fat. Each food within these groups is broken into a quantity that contains the following:

Diabetic Exchange List macros

Because each exchange conforms roughly to to these specified calories and macronutrients, diets of particular calorie levels can be made by distributing exchanges of each type evenly across the day. I won’t get into exactly how this is done because I might lose people, but if you want to know you can ask in the comments and I’d be happy to elaborate.

How will this help me lose weight?

Well my friend, weight loss is a very simple concept. Calories consumed in food MUST BE LESS THAN calories burned by exercise and just by being alive. Using an outline of exchanges, then “filling in” those exchanges with foods according to your tastes will ensure that your meals have the appropriate number of calories in them.

How will this help me keep my energy up?

As previously discussed, energy is a function of having a highly nutritious diet that includes carbohydrate in appropriate amounts spaced evenly throughout your day. The diabetic exchange meal plans were created to do exactly this – the main goal of these plans is to ensure steady blood sugar for those with diabetes, since their bodies aren’t as good at regulating it with hormones. Consistent blood sugar = steady energy!

What does this look like in practice?

  1. Determine the number of calories you need to be eating. Try out this algorithm or this simpler equation
  2. Find the appropriate diabetic exchange meal plan for you. I like the ones put out by Novo Nordisk. They won’t have a plan for the EXACT calories calculated – think 1200, 1500, 1800, 2000, 2200 – but find one within 200 calories of your calculated calorie needs. This meal plan will give you a set number of specific types of exchanges for breakfast, lunch, dinner, and snacks.
  3. Use the food exchange lists to look up a food that you want to include in your meal, then determine what quantity one exchange of that food is so that you can appropriately determine the quantity of that food at your meal. (If you want the one I send to patients, just shoot me an email).
  4. Repeat for all meals and snacks until you have your whole day planned out.
  5. I often recommend that patients come up with at least three different options for each meal the first time they sit down and do some planning so they have a few go-to options already mapped out.


In this 1500 calorie meal plan, breakfast exchanges are as follows:

  • 1 starch
  • 1 fat
  • 1 meat
  • 1 fruit
  • 1 milk

Let’s say I wanted to eat oatmeal for breakfast. I’d open up my carb counting document and look for oats, finding that one exchange of oats is equal to 1/3 cup. So we’ve got our starch exchange. Now let’s say I want to put some raisins in those oats for my fruit. Look up raisins – 2 tablespoons. So we’ve got 1/2 cup oats with 2T raisins. I’ll cook my cereal with my milk, so 1 cup skim milk is my exchange there. Now I just need a meat and a fat – an egg on the side and 2 chopped pecans to top my oatmeal meets those criteria. So now instead of having a list of exchanges, we have the following meal:

  • 1/2 cup oats, cooked in
  • 1 cup skim milk, with
  • 2 T raisins, topped with
  • 2 chopped pecans, alongside
  • 1 egg

Ta-da! Below is a full day example of how you might bring a 1500 calorie meal plan to life:

1500 calorie diabetic exchange


Your planned meals will automatically add up to the calorie level you have chosen, eliminating the need for a tracking app like My Fitness Pal to ensure you’re hitting the right number of calories


This method requires a lot of front-end legwork and planning. You need to make sure you have a bunch of meals that you know will fit the bill. Normally it’s a matter of switching around quantities of foods, but it still takes focus. Additionally, it can be hard to stick to for vegetarians and vegans, especially if the main source of protein is legumes. Since legumes count as 1 starch and 1 protein exchange, starch exchanges get really tough to keep to the required amounts.

What if I can’t find a plan with the right number of calories?

Like I said, it’s not going to be exact if you use one of the ones floating around out there on the internet. If you work with a Registered Dietitian, he or she should be able to tailor it more specifically to your nutrient needs.

What if I don’t drink milk? Can I used almond milk?

Well, a couple things. Yogurt is also included in the milk products, so that can count for your milk exchanges. ALMOND MILK DOES NOT COUNT AS A MILK PRODUCT!!!!! It will not even come close to hitting the macronutrients you’re looking for, since it’s really just almond flavored water. Milk products needed to get their own category because they’re commonly consumed items that are part of a healthy diet and which contain carbohydrate in the form of lactose. If a diabetic person who really needs to keep carbohydrate consistent did not account for milk consumption in their meal plan, their blood sugar would way up with every glass of milk consumed. In the interest of keeping carbohydrate consistent, you can switch your milk exchanges out for another carbohydrate exchange (i.e. a starch or a fruit) if you so choose, but you will lose the 8g protein that you’d get from the milk. That, however, is some advanced diabetic exchange planning and we can talk about that in a counseling session if you’d like 🙂


Overall, the exchange lists are a great way to provide structure if you’re one of those people who needs it for weight loss success. If you’re a planner, it’s a great method to try!


One response to “Diabetic exchange meal planning – not just for diabetes!

  1. Lauren,

    In the example is the 1/3 cup oatmeal a typo as you say 1/2 cup later (in two different places below the first 1/3 comment)?

    Thanks for this post! I need to spend more time on it as diabetes runs in my family and I need to be cautious.



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