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October 4, 2001

Meal Planning, Food and Diet

Question from Inverness, Great Britain:

In Britain, I was taught only to measure carbohydrates. Then I was told not to measure them but to make sure I get enough in my diet to cover my insulin. Why is it that in America, you measure the protein, carbohydrates, vegetables and fruit?

Answer:

I think the question that you are getting at is the difference between exchange lists and carbohydrate counting for diabetes meal planning. Both are effective meal planning techniques, the only difference is the focus on nutrients and how they affect blood sugars.

Carb counting (as the name implies) stresses that the individual count their servings of carbohydrate and spread them out during the day. The premise behind this method of meal planning is that carbs affect postprandial blood sugars the fastest and have the biggest impact. Protein and fats [the other two macronutrients] are still important with respect to weight control and postprandial blood sugar control, but not as much as carbs.

Exchange lists stress a combination of all three macronutrients and the individual counts servings of milk, starch, proteins, fats, fruit, and vegetables. Exchange lists allow for flexibility in the meal plan because equivalent servings from similar categories can be “exchanged”. Hope this helps explain the difference in what you were told..

JMS