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THE
EXCHANGE
SYSTEM
The Exchange System:
What is it?
▪ Food classification method
▪ Created for diabetics by ADA & ADA
▪ Track Calories, CHO’s, PRO, FAT
▪ Healthy way of eating
2
3
Athlete Nutrition
 Awareness of macronutrient
composition
 Allows dietitian/nutritionist to estimate
Calorie and macronutrient intake
 Diet analysis
 Customize meal plans
FOOD EXCHANGE LIST (FEL)
4
1 3 5
6
4
2
Identification of
commonly used
food items
Portion size
weighing &
measurement of
each food item
Consultation with
experts,
nutritionist,
dietitians
Portion size
computation
Pre-production of
the prototype
book
Review by
selected users
Foods in the Exchange
System
 Divided by chemical composition re:
 Macronutrients
 Specified portions of foods in each group are
exchangeable with the other foods in that group
 So in the fruit list, ½ cup orange juice can be
exchanged for a cup of strawberries without
increasing calories and carb grams.
5
FOOD GROUPS:
Foods classified into 7 groups:
 Vegetable
 Fruit
 Starch
 Milk
 Meat/meat substitutes
 Fat
 Sugar
6
Vegetable Group
▪ 3 g carbohydrate
▪ 1 g protein
▪ 0 g fat
▪ 16 Calories
▪ Examples:
▫ ½ Cup cooked spinach
▫ 1 Cup baby carrots
▫ 1 Cup diced tomatoes
▫ 1 Cup cucumbers
7
8
Only vegetables that contains 16
calories per exchange
were included in the vegetable
exchange list
Fruit Group
▪ 10 g carbohydrate
▪ 0 g protein
▪ 0 g fat
▪ 40 Calories
▪ Examples:
▫ 1 small banana
▫ 1 ¼ Cups strawberries
▫ ½ Cup orange juice
▫ ¾ Cup fresh pineapple 9
Milk Group
10
CLASSIFICATION CARBOHYDRATE PROTEIN FAT ENERGY
Whole 12 g 8 g 10 g 170 kcal
Low Fat 12 g 8 g 5 g 125 kcal
Skimmed/Non-
fat/Fat-free 12 g 8 g - 80 kcal
Examples:
• 1 Cup non-fat milk
• 1 Cup soy milk
• 2/3 Cup fat-free, artificially sweetened yogurt
Starch Group
11
CLASSIFICATION CARBOHYDRATE PROTEIN FAT ENERGY
Rice A – Low Protein 23 g - - 92 kcal
Rice B – Medium Protein 23 g 2 g - 100 kcal
Rice C – High Protein 23 g 4 g - 108 kcal
Examples:
• ½ Cup oatmeal
• 1 Avg. slice bread
• ½ Hamburger bun
• ½ Cup corn/peas
Meat/Meat Substitutes
12
CLASSIFICATION CARBOHYDRATE PROTEIN FAT ENERGY
Low Fat - 8 g 1 g 41 kcal
Medium - 8 g 6 g 86 kcal
High Fat - 8 g 10 g 122 kcal
Examples:
• ¼ Cup egg substitutes;
• white meat poultry,
• no skin1 oz lean cut beef
• 1 egg; poultry w/skin, fried fish
• 1 oz of most cheeses, sausages;
Fat Group
▪ 0 g carbohydrate
▪ 0 g protein
▪ 5 g fat
▪ 45 Calories
▪ Examples:
▫ 1 tsp oil
▫ ½ Tbsp peanut butter
▫ 1 Tbsp reduced-fat mayo
▫ 1 Tbsp cream cheese
▫ Avacado
13
Sugar Group:
▪ 5 g carbohydrate
▪ 0 g protein
▪ 0 g fat
▪ 20 Calories
14
15
Diet Prescription
#1:
 Calculate energy needs
 Male, 75 kg, runner
 3000 Cal/day
Diet Prescription
16
▪ Calculate g CHO, PRO, FAT
▪ ACSM & ADA
 CHO:
 6-10 g CHO/kg BW
 PRO:
▫ Endurance: 1.2 – 1.4 g PRO/kg BW
▫ Power: 1.6- 1.7 g PRO/kg BW
#1:
17
Calculate g CHO, PRO, FAT
Example:
▪ 75 kg x 6 g/kg BW = 450 g CHO = 1800 Cal
▪ 75 kg x 1.4 g/kg BW = 105 g PRO = 420 Cal
▪ 1800+420 = 2220 Cal
▪ 3000 – 2220 = 780 Cal left for FAT
▪ 780 Cal FAT = 87 g FAT
#1 cont’d
18
Diet Prescription
#2:
Figure no of exchanges for CHO-containing food groups
Follow this order:**
• Milk
• Fruit
• Vegetable
***Always begin with
CHO-containing food
groups
19
Diet Prescription
#3: Add all of the carbohydrates you have used so far
for milk, fruit, & veggie exchanges.
 Subtract from total g CHO.
 Divide by 23.
 This is how many starch exchanges you will have.
20
Diet Prescription
#4: Add grams of protein used thus far for milk, veggie, &
starch exchanges. Subtract from total grams of protein.
 Subtract from total grams of protein.
 Divide by 8.
 This is how many meat exchanges you are allotted.
21
#5: Add grams of protein used thus far for milk, veggie, and
starch exchanges. Subtract from total grams of protein.
 Subtract from total grams of protein.
 Divide by 5.
 This is how many fat exchanges you will have.
#6: Add Cal from each food group to double check your work.
 Be sure you are near your total Cal/day.
STEP 1:
22
List Food No. of Exchanges Carbohydrate(g) Protein(g) Fat(g) Energy(kcal)
I Vegetable 3 9 3 - 48
II Fruit 5 50 - - 200
III Milk 1 12 8 10 170
VII Sugar 3 15 - - 60
Diet Prescription: 1,500 kcal,
Carbohydrate 245 g, Protein 55 g, Fat 35 g
23
Carbohydrate partial sum
= 9 g + 50 g + 12 g +15 g = 86 g
No. of Rice exchanges:
245 g (prescribed carbohydrate)
-86 g (partial sum carbohydrate)
------------------------------------
=159 g
159 g ÷ 23 g
= 6.91 or 7 Rice exchanges
STEP 2:
24
List Food No. of Exchanges Carbohydrate(g) Protein(g) Fat(g) Energy(kcal)
IV
Rice A 1 23 - - 92
Rice B 5 115 10 - 500
Rice C 1 23 4 - 108
Diet Prescription: 1,500 kcal,
Carbohydrate 245 g, Protein 55 g, Fat 35 g
25
Protein partial sum
= 3 g + 8 g + 10 g + 4 g = 25 g
No. of Meat exchanges:
55 g (prescribed protein)
-25 g (protein partial sum)
------------------------------------
=35 g
35 g ÷ 8 g
= 3.75 or 4 Meat exchanges
STEP 3:
26
List Food No. of Exchanges Carbohydrate(g) Protein(g) Fat(g) Energy(kcal)
V
LF Meat 2 - 16 2 82
MF Meat 2 - 16 12 172
Diet Prescription: 1,500 kcal,
Carbohydrate 245 g, Protein 55 g, Fat 35 g
27
Fat partial sum
= 10 g + 2 g + 12 g = 24 g
No. of Fat exchanges:
35 g (prescribed protein)
-24g (protein partial sum)
------------------------------------
=11 g
11 g ÷ 5 g
= 2.2 or 2 Fat exchanges
STEP 4:
28
Diet Prescription: 1,500 kcal,
Carbohydrate 245 g, Protein 55 g, Fat 35 g
List Food No. of Exchanges Carbohydrate(g) Protein(g) Fat(g) Energy(kcal)
VI Fat 2 - - 10 90
Total 247 57 34 1522
29
30
Are you ready
to prepare an MEAL PLAN?

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Food exchange

  • 2. The Exchange System: What is it? ▪ Food classification method ▪ Created for diabetics by ADA & ADA ▪ Track Calories, CHO’s, PRO, FAT ▪ Healthy way of eating 2
  • 3. 3 Athlete Nutrition  Awareness of macronutrient composition  Allows dietitian/nutritionist to estimate Calorie and macronutrient intake  Diet analysis  Customize meal plans
  • 4. FOOD EXCHANGE LIST (FEL) 4 1 3 5 6 4 2 Identification of commonly used food items Portion size weighing & measurement of each food item Consultation with experts, nutritionist, dietitians Portion size computation Pre-production of the prototype book Review by selected users
  • 5. Foods in the Exchange System  Divided by chemical composition re:  Macronutrients  Specified portions of foods in each group are exchangeable with the other foods in that group  So in the fruit list, ½ cup orange juice can be exchanged for a cup of strawberries without increasing calories and carb grams. 5
  • 6. FOOD GROUPS: Foods classified into 7 groups:  Vegetable  Fruit  Starch  Milk  Meat/meat substitutes  Fat  Sugar 6
  • 7. Vegetable Group ▪ 3 g carbohydrate ▪ 1 g protein ▪ 0 g fat ▪ 16 Calories ▪ Examples: ▫ ½ Cup cooked spinach ▫ 1 Cup baby carrots ▫ 1 Cup diced tomatoes ▫ 1 Cup cucumbers 7
  • 8. 8 Only vegetables that contains 16 calories per exchange were included in the vegetable exchange list
  • 9. Fruit Group ▪ 10 g carbohydrate ▪ 0 g protein ▪ 0 g fat ▪ 40 Calories ▪ Examples: ▫ 1 small banana ▫ 1 ¼ Cups strawberries ▫ ½ Cup orange juice ▫ ¾ Cup fresh pineapple 9
  • 10. Milk Group 10 CLASSIFICATION CARBOHYDRATE PROTEIN FAT ENERGY Whole 12 g 8 g 10 g 170 kcal Low Fat 12 g 8 g 5 g 125 kcal Skimmed/Non- fat/Fat-free 12 g 8 g - 80 kcal Examples: • 1 Cup non-fat milk • 1 Cup soy milk • 2/3 Cup fat-free, artificially sweetened yogurt
  • 11. Starch Group 11 CLASSIFICATION CARBOHYDRATE PROTEIN FAT ENERGY Rice A – Low Protein 23 g - - 92 kcal Rice B – Medium Protein 23 g 2 g - 100 kcal Rice C – High Protein 23 g 4 g - 108 kcal Examples: • ½ Cup oatmeal • 1 Avg. slice bread • ½ Hamburger bun • ½ Cup corn/peas
  • 12. Meat/Meat Substitutes 12 CLASSIFICATION CARBOHYDRATE PROTEIN FAT ENERGY Low Fat - 8 g 1 g 41 kcal Medium - 8 g 6 g 86 kcal High Fat - 8 g 10 g 122 kcal Examples: • ¼ Cup egg substitutes; • white meat poultry, • no skin1 oz lean cut beef • 1 egg; poultry w/skin, fried fish • 1 oz of most cheeses, sausages;
  • 13. Fat Group ▪ 0 g carbohydrate ▪ 0 g protein ▪ 5 g fat ▪ 45 Calories ▪ Examples: ▫ 1 tsp oil ▫ ½ Tbsp peanut butter ▫ 1 Tbsp reduced-fat mayo ▫ 1 Tbsp cream cheese ▫ Avacado 13
  • 14. Sugar Group: ▪ 5 g carbohydrate ▪ 0 g protein ▪ 0 g fat ▪ 20 Calories 14
  • 15. 15 Diet Prescription #1:  Calculate energy needs  Male, 75 kg, runner  3000 Cal/day Diet Prescription
  • 16. 16 ▪ Calculate g CHO, PRO, FAT ▪ ACSM & ADA  CHO:  6-10 g CHO/kg BW  PRO: ▫ Endurance: 1.2 – 1.4 g PRO/kg BW ▫ Power: 1.6- 1.7 g PRO/kg BW #1:
  • 17. 17 Calculate g CHO, PRO, FAT Example: ▪ 75 kg x 6 g/kg BW = 450 g CHO = 1800 Cal ▪ 75 kg x 1.4 g/kg BW = 105 g PRO = 420 Cal ▪ 1800+420 = 2220 Cal ▪ 3000 – 2220 = 780 Cal left for FAT ▪ 780 Cal FAT = 87 g FAT #1 cont’d
  • 18. 18 Diet Prescription #2: Figure no of exchanges for CHO-containing food groups Follow this order:** • Milk • Fruit • Vegetable ***Always begin with CHO-containing food groups
  • 19. 19 Diet Prescription #3: Add all of the carbohydrates you have used so far for milk, fruit, & veggie exchanges.  Subtract from total g CHO.  Divide by 23.  This is how many starch exchanges you will have.
  • 20. 20 Diet Prescription #4: Add grams of protein used thus far for milk, veggie, & starch exchanges. Subtract from total grams of protein.  Subtract from total grams of protein.  Divide by 8.  This is how many meat exchanges you are allotted.
  • 21. 21 #5: Add grams of protein used thus far for milk, veggie, and starch exchanges. Subtract from total grams of protein.  Subtract from total grams of protein.  Divide by 5.  This is how many fat exchanges you will have. #6: Add Cal from each food group to double check your work.  Be sure you are near your total Cal/day.
  • 22. STEP 1: 22 List Food No. of Exchanges Carbohydrate(g) Protein(g) Fat(g) Energy(kcal) I Vegetable 3 9 3 - 48 II Fruit 5 50 - - 200 III Milk 1 12 8 10 170 VII Sugar 3 15 - - 60 Diet Prescription: 1,500 kcal, Carbohydrate 245 g, Protein 55 g, Fat 35 g
  • 23. 23 Carbohydrate partial sum = 9 g + 50 g + 12 g +15 g = 86 g No. of Rice exchanges: 245 g (prescribed carbohydrate) -86 g (partial sum carbohydrate) ------------------------------------ =159 g 159 g ÷ 23 g = 6.91 or 7 Rice exchanges
  • 24. STEP 2: 24 List Food No. of Exchanges Carbohydrate(g) Protein(g) Fat(g) Energy(kcal) IV Rice A 1 23 - - 92 Rice B 5 115 10 - 500 Rice C 1 23 4 - 108 Diet Prescription: 1,500 kcal, Carbohydrate 245 g, Protein 55 g, Fat 35 g
  • 25. 25 Protein partial sum = 3 g + 8 g + 10 g + 4 g = 25 g No. of Meat exchanges: 55 g (prescribed protein) -25 g (protein partial sum) ------------------------------------ =35 g 35 g ÷ 8 g = 3.75 or 4 Meat exchanges
  • 26. STEP 3: 26 List Food No. of Exchanges Carbohydrate(g) Protein(g) Fat(g) Energy(kcal) V LF Meat 2 - 16 2 82 MF Meat 2 - 16 12 172 Diet Prescription: 1,500 kcal, Carbohydrate 245 g, Protein 55 g, Fat 35 g
  • 27. 27 Fat partial sum = 10 g + 2 g + 12 g = 24 g No. of Fat exchanges: 35 g (prescribed protein) -24g (protein partial sum) ------------------------------------ =11 g 11 g ÷ 5 g = 2.2 or 2 Fat exchanges
  • 28. STEP 4: 28 Diet Prescription: 1,500 kcal, Carbohydrate 245 g, Protein 55 g, Fat 35 g List Food No. of Exchanges Carbohydrate(g) Protein(g) Fat(g) Energy(kcal) VI Fat 2 - - 10 90 Total 247 57 34 1522
  • 29. 29
  • 30. 30 Are you ready to prepare an MEAL PLAN?