Choose Your Foods: Exchange Lists for Diabetes, Sixth Edition, 2008: Description and Guidelines for Use

Abstract

Choose Your Foods: Exchange Lists for Diabetes (formerly Exchange Lists for Meal Planning), a booklet used to help people with diabetes plan meals, has been in existence for more than 50 years. Planning for the fifth revision was guided by survey responses from >3,000 registered dietitians and other health professionals, current diabetes management and nutrition recommendations, and the food marketplace. In addition to a name change, major changes were made in design and overall readability. Changes within food groupings and the addition of a number of foods (mainly ethnic/regional) were accomplished while maintaining the well-recognized and accepted mean macronutrient and energy values of the basic lists. As with previous editions, this publication is intended as a resource for use by individuals with diabetes, with the guidance of a registered dietitian. This booklet is also intended to be used as a basis for nutrition educational materials developed by the American Dietetic Association and American Diabetes Association (eg, carbohydrate counting, weight management) and as a method for students and others to learn about diabetes meal planning. Practical guidelines for use of this updated resource for meal planning (eg, sugar alcohols, dietary fiber, and alcohol) are also presented.

Full text

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OF PROFESSIONAL INTEREST
Choose Your Foods: Exchange Lists for Diabetes,
Sixth Edition, 2008: Description and Guidelines for Use
Madelyn L. Wheeler, MS, RD, FADA; Anne Daly, MS, RD; Alison Evert, MS, RD;
Marion J. Franz, MS, RD; Patti Geil, MS, RD, FADA; Lea Ann Holzmeister, RD;
Karmeen Kulkarni, MS, RD; Emily Loghmani, MS, RD; Tami A. Ross, RD; Pamela Woolf
ABSTRACT
Choose Your Foods: Exchange Lists for
Diabetes (formerly Exchange Lists for
Meal Planning), a booklet used to help
people with diabetes plan meals, has
been in existence for more than 50
years. Planning for the fifth revision
was guided by survey responses from
⬎3,000 registered dietitians and other
health professionals, current diabetes
management and nutrition recommen-
dations, and the food marketplace. In
addition to a name change, major
changes were made in design and over-
all readability. Changes within food
groupings and the addition of a number
of foods (mainly ethnic/regional) were
accomplished while maintaining the
well-recognized and accepted mean
macronutrient and energy values of the
basic lists. As with previous editions,
this publication is intended as a re-
source for use by individuals with dia-
betes, with the guidance of a registered
dietitian. This booklet is also intended
to be used as a basis for nutrition edu-
cational materials developed by the
American Dietetic Association and
American Diabetes Association (eg,
carbohydrate counting, weight man-
agement) and as a method for students
and others to learn about diabetes meal
planning. Practical guidelines for use of
this updated resource for meal plan-
ning (eg, sugar alcohols, dietary fiber,
and alcohol) are also presented.
J Am Diet Assoc. 2008;108:883-888.
In 1950, the first edition of the Ex-
change Lists for Meal Planning
booklet (1) was developed by the
American Dietetic Association, the
American Diabetes Association, and
the United States Public Health Ser-
vice. The goal was to provide a set of
food values for estimating nutrients
and energy for meal plans for people
with diabetes, a short method for cal-
culating the diet, and several lists of
foods of similar values. Since that
time, the booklet has been updated
four times (2-4). Because of recent ad-
vancements in diabetes management,
the evolving evidence base for nutri-
tion recommendations for people with
diabetes, and changes in the food
marketplace and the eating patterns
of Americans, this booklet has been
revised again.
DIABETES/NUTRITION RECOMMENDATIONS
The American Diabetes Association
has recently updated its nutrition
recommendations (5) and the Amer-
ican Dietetic Association has up-
dated and expanded the Evidence
Analysis Library recommendations
for type 1 and type 2 diabetes (6).
Medical nutrition therapy is essen-
tial to help people with diabetes ac-
complish the goals of achieving and
maintaining (a) blood glucose close
to or at the normal range, (b) a lipid
and lipoprotein profile that reduces
risk for vascular disease, and (c)
blood pressure close to or at the nor-
mal range. A registered dietitian is
the health professional recommended
to provide medical nutrition therapy
(5,6). Studies employing a variety of
nutrition interventions using medical
nutrition therapy report a reduction
in hemoglobin A1c levels, improved
lipid profiles, improved weight man-
agement, decreased need for medica-
tions, and reduction in risk for onset
and progression of comorbidities (6).
Nutrition interventions include ad-
justing insulin doses to match carbo-
M. L. Wheeler is coordinator, Nutritional Computing Concepts, Zionsville,
IN. A. Daly is director of nutrition and diabetes education, Springfield Dia-
betes and Endocrine Center, Springfield, IL. A. Evert is a diabetes nutrition
educator, University of Washington Medical Center, Diabetes Care Center,
Seattle. M. Franz is a nutrition/health consultant, Nutrition Concepts by
Franz, Inc, Minneapolis, MN. P. Geil is a certified diabetes educator, Geil
Nutrition Communications, Lexington, KY. L. A. Holzmeister is a certified
diabetes educator, Holzmeister Nutrition Communications, LLC, Tempe, AZ.
K. Kulkarni is director of Scientific Affairs, Intensive Diabetes Management,
Abbott Diabetes Care, Salt Lake City, UT. E. Loghmani is a diabetes educa-
tor, Endocrinology and Diabetes Consultants, an Affiliate of Wentworth-
Douglass Hospital, Dover, NH. T. A. Ross is a diabetes nutrition educator,
Internal Medicine Associates, Lexington, KY. P. Woolf is with the American
Health Information Management Association; at the time of the study, she
was a development editor, American Dietetic Association, Chicago, IL. M. L.
Wheeler, A. Daly, A. Evert, M. Franz, P. Geil, L. A. Holzmeister, K. Kul-
karni, E. Loghmani, and T. A. Ross are also certified diabetes educators.
Address correspondence to: Madelyn L. Wheeler, MS, RD, FADA, Nutri-
tional Computing Concepts, 5014 Turkey Foot Rd, Zionsville, IN 46077.
E-mail: mlwheele@iupui.edu
Copyright © 2008 by the American Dietetic Association.
0002-8223/08/10805-0014$34.00/0
doi: 10.1016/j.jada.2008.02.002
©2008 by the American Dietetic Association Journal of the AMERICAN DIETETIC ASSOCIATION 883

hydrate intake, consistency in carbo-
hydrate intake, weight management,
increasing fiber to meet the Ade-
quate Intake (14 g/1,000 kcal) recom-
mended by the Dietary Reference In-
takes (7), limiting saturated fats to
⬍7% of total calories, minimizing
trans fats, lowering cholesterol to
⬍200 mg/day, and reducing sodium
intake to ⬍2,300 mg/day. Monitoring
carbohydrate intake, either by carbo-
hydrate counting, exchanges, or expe-
rienced-based estimation, is a key
intervention in achieving glycemic
control. Specific food recommenda-
tions include increased use of fruits,
vegetables, whole grains, and le-
gumes, as well as low-fat dairy prod-
ucts and lean meats rather than full-
fat products, and unsaturated fats
rather than saturated fats.
SURVEY/QUESTIONNAIRE
The process for the fifth revision was
initiated by the American Dietetic As-
sociation with an online survey sent
to 14,000 members of the American
Dietetic Association (particularly the
Diabetes Care and Education and
Weight Management practice groups),
the American Diabetes Association,
and the American Association of Dia-
betes Educators. The survey was of
the exempt type and did not require
institutional review board approval
or informed consent. Questions were
both closed (yes or no) and open-
ended. Three-thousand and eighty-
eight (22%) usable responses were re-
ceived. Because the philosophy of food
grouping for healthful meal planning
is basic to diabetes education, and is
used for other meal planning meth-
ods, such as carbohydrate counting as
well as weight management, the sur-
vey indicated that the booklet should
be retained and updated. The recom-
mendations were summarized into
five categories: title, food list group-
ings and foods within the lists
(eg, more cultural diversity), sidebar
ideas, design (eg, color coding), and
other considerations (eg, more gener-
alized diabetes health care informa-
tion, more emphasis on readability).
This revision is based on the survey
results, nutrition recommendations
(5,6), and an update of foods available
in the marketplace.
SUMMARY OF CHANGES
Title of Booklet
The survey indicated that use of the
word exchanges was outdated and
confusing to many; on the other hand,
the word has recognition for both or-
ganizations. Therefore, the title was
changed to “Choose Your Foods,” but
includes a subtitle (Exchange Lists for
Diabetes) so that health professionals
and the public would know this is a
revision rather than a completely new
concept (Figure 1).
Food List Groupings, and Foods
within the Lists
The basic philosophy of this publica-
tion has always been the grouping of
foods into general categories (or lists)
that, per serving size, are similar in
macronutrients and calories. While
the lists generally remain the same as
in previous editions, changes have
been made so they are easier to use.
For example:
●The “starch⫹fat” category has been
deleted from the Starch List.
●A “dairy-like products” category
(eg, soy and rice milks, smoothies)
has been added to the Milk List.
●Leafy greens have moved from the
Figure 1. Choose Your Foods: Exchange Lists for Diabetes cover page. © 2008 American
Diabetes Association and American Dietetic Association. Reprinted with permission.
OF PROFESSIONAL INTEREST
884 May 2008 Volume 108 Number 5

Nonstarchy Vegetable List to the
Free Foods List.
●Very lean meats have been inte-
grated into the Lean Meat List, and a
new category has been added to the
Meats and Meats Substitute Group,
the Plant-Based Protein List.
●Several lists (Sweets, Desserts and
Other Carbohydrates, Combination
Foods, and Fast Foods) have been
subdivided for ease of use.
●An Alcohol List has been added
to provide adults who choose to
drink with information (in alcohol
equivalents) about calories and
carbohydrates.
Foods within the lists have been
updated. While a few foods were de-
leted, a number were added, with the
total being represented by ⬎700 foods
in the updated data set accompanying
this revision. Foods were selected
based on current common use and
wide availability (8,9).
To verify the average energy and ma-
cronutrient values used in the latest
set of food lists and to determine the
most appropriate serving sizes for
matching the list average values, the
previous Exchange Lists for Meal Plan-
ning data set (10) was the initial start-
ing point. The United States De-
partment of Agriculture’s Nutrient
Database for Standard Reference (11)
was used to obtain or update nutri-
ent values for each individual food.
Where this database was inadequate,
information from nutrition labels of
several brands of the food item were
averaged. Nutrient information for a
few foods was obtained from the United
States Department of Agriculture’s
Food and Nutrient Database for Di-
etary Studies (12). The Table provides
the average group macronutrient and
energy values and the means per serv-
ing of all foods in each of the food lists
for Choose Your Foods. This should re-
assure users that each food in a list, in
the serving size given, is reflective of
the rounded averages; however, it is
also a reminder that while the means
are close to the average values, the
standard deviation indicates a range
for each group.*
Sidebars
Many sidebars and boxes provide sug-
gestions to help people with diabetes
better manage the food selection com-
ponent for controlling their diabetes:
concepts such as energy balance and
helpful suggestions for portion sizes,
smart supermarket shopping, eating
more vegetables, ground beef label-
ing, and reducing trans fats. Increas-
ing physical activity is also covered,
in a “Get Moving” section. In addition,
the nutrition and food selection tips
for each list have been updated to re-
flect current food choices of the popu-
lation and increased availability of a
variety of foods and food products.
Design
Overall the booklet was designed to
be more user-friendly. For example:
●A“table” design is used to help
readers follow a food across the
page to the amount.
●Color-coding separates the food
groups: brown for starches; orange
for fruits; blue for milk; green for
vegetables; red for meats and sub-
stitutes; and yellow for fats.
●Flagging is used to alert readers
to foods high in sodium and good
sources of fiber. Following guidelines
*The complete nutrient data set
may be accessed by going to the
American Dietetic Association’s Web
site, Food and Information section
(www.eatright.org/knowledgecenter,
then choose the Food Nutrient Data-
set under “Consumer Resources.” Ac-
cessed April 4, 2008.).
Table. Macronutrient and energy values assigned to each food list compared to a mean of all foods within each list
Food list n Carbohydrate (g) Protein (g) Fat (g) Calories
4™™™™™™™™™™™™™™ Average (mean⫾standard deviation) ™™™™™™™™™™™™™™3
Carbohydrates
Starch: breads, cereals and grains, starchy
vegetables, crackers and snacks, and
beans, peas and lentils 112 15 (16.0⫾3.2) 0-3 (2.8⫾1.9) 0-1 (1.3⫾1.6) 80 (84⫾20)
Fruit 50 15 (15.2⫾2.0) — (0.8⫾0.4) — (0.2⫾0.2) 60 (61⫾7)
Milk
Fat-free, low-fat, 1% 8 12 (12.5⫾1.1) 8 (8.5⫾0.8) 0-3 (1.1⫾1.1) 100 (95⫾11)
Reduced-fat, 2% 5 12 (10.8⫾3.4) 8 (7.6⫾1.5) 5 (4.5⫾0.8) 120 (120⫾17)
Whole 4 12 (11.9⫾0.7) 8 (8.6⫾0.4) 8 (8.9⫾1.1) 160 (162⫾9)
Sweets, desserts, and other carbohydrates
a
68 15 Varies Varies Varies
Nonstarchy vegetables 67 5 (4.8⫾2.5) 2 (1.3⫾0.7) — (0.2⫾0.3) 25 (23⫾11)
Meat and meat substitutes
Lean 78 — (0.6⫾1.1) 7 (7.1⫾1.5) 0-3 (1.6⫾1.1) 45 (46⫾12)
Medium-fat 32 — (0.5⫾0.8) 7 (6.9⫾1.5) 4-7 (4.6⫾1.1) 75 (72⫾9)
High-fat 26 — (0.7⫾0.6) 7 (5.7⫾1.6) 8⫹(8.2⫾1.3) 100 (100⫾14)
Plant-based proteins
a
17 Varies 7 Varies Varies
Fat 72 — (1.1⫾1.4) — (0.7⫾1.0) 5 (4.4⫾0.9) 45 (46⫾10)
Free foods 91 — (2.0⫾1.6) — (0.6⫾1.0) — (0.3⫾0.6) — (13⫾8)
Combination foods
a
30 15 Varies Varies Varies
Fast foods
a
30 15 Varies Varies Varies
Alcohol
a
7 Varies — — 100
a
Five lists do not contain mean⫾standard deviation because of wide macronutrient or caloric variability.
OF PROFESSIONAL INTEREST
May 2008 ●Journal of the AMERICAN DIETETIC ASSOCIATION 885

from the Code of Federal Regulations
for use of the term healthy in food
labeling, a food is flagged as high in
sodium if a serving contains ⬎480
mg sodium, and a main dish/meal is
flagged if a serving contains ⬎600
mg sodium (13). The Code of Federal
Regulations indicates that to define a
food as a “good source” of fiber, it
should contain 10% to 19% of the Di-
etary Reference Intake for fiber (14).
Thus, those foods containing ⬎3g
fiber/serving have been flagged. A
third flag is the symbol to alert peo-
ple when to “add a fat” (eg, a starch
with an added fat).
Other Considerations
The booklet is written for a reading
level of 6th grade or less and contains
a number of small colorful food pic-
tures to provide visual emphasis.
While keeping essential content, the
introduction was reduced. The glos-
sary has been extensively revised and
now includes basic diabetes informa-
tion as well as food/nutrient informa-
tion. In addition, an extensive index
has been included to assist in finding
specific foods easily.
Guidelines for Food and Meal Planning
Using the Choose Your Foods Booklet
The booklet contains a “Your Meal
Plan” page for use in individualized
meal planning or for assessing food
intake. There is a small area for
personalization of nutritional goals
(calories, percent of calories as carbo-
hydrate, grams or choices of carbohy-
drate, grams of fat and protein) and a
simple meal-planning template table.
The template lists the main food
groups in a set of vertical columns,
with six rows for main meals and
snacks. A final column is available for
meal suggestions. An amount (eg,
number of choices or grams of carbo-
hydrate) can be inserted into each
block. Or, this template, along with
the carbohydrate, fat, protein, and
calorie values assigned to each food
group (Table) can be used for evalu-
ating food intake for the nutrition as-
sessment. Guidelines for using Choose
Your Foods in helping people with di-
abetes accomplish healthy meal plan-
ning follow:
1. Each list general macronutrient
and energy values are based on a
range of individual food values.
Calculations of food intake based
on the Choose Your Foods booklet
are not accurate enough for single-
digit precision. Estimates of en-
ergy in calculated meal plans
should be rounded off, for example
to the nearest 50 to 100 kcal.
2. Recommending a wide variety of
foods is important when planning
meals. A food pattern that includes
carbohydrate from fruits, vegeta-
bles, whole grains, legumes, and
low-fat dairy products should be
encouraged for good health. In ad-
dition, individuals should be en-
couraged to choose foods from the
Lean Meat/Plant-Based Protein
Lists of the Meats and Meat Sub-
stitutes Group, and the Mono- and
Polyunsaturated Fat Lists from
the Fat Group.
3. Percentages of macronutrients in
the meal plan should be based on
metabolic goals and the ability,
need, and willingness of the person
with diabetes to make lifestyle
changes (5,6). While there is no
carbohydrate percentage of energy
recommended specifically for people
with diabetes, it is not unreason-
able to use the Dietary Reference
Intakes’ Acceptable Macronutrient
Distribution Range of 45% to 65%
of total daily energy for both adults
and children (15).
4. Carbohydrate choices is a concept
used in this booklet and is based
on the fact that foods in the Starch,
Fruit, and Milk Lists of the Carbo-
hydrate Group each contain simi-
lar carbohydrate (⬃15 g) and en-
ergy (⬃80 kcal) content per serving
and thus they can be interchanged:
●One serving of starch, fruit
or milk⫽1 carbohydrate choice
(about 15 g carbohydrate). Pos-
sible problems need to be an-
ticipated and, in some cases,
individualized guidelines for in-
terchanging foods need to be pro-
vided. For example, if regular
substitution of fruits or starches
for milk is made, calcium intake
may be decreased and protein
(eg, for children) may be reduced
considerably.
●The sample meal plan page does
not include several of the lists
within this booklet. The Sweets,
Desserts and Other Carbohy-
drates, the Combination Foods,
and the Fast Foods have their
foods listed in a “count as” col-
umn, as xamount of carbohy-
drate, or xamount of carbohy-
drate ⫹yamount of fat. In the
case of dairy-like products in-
cluded within the milk list (eg,
soy milk), foods are listed as x
amount of carbohydrate and per-
haps yamount of fat and z
amount of milk choices.
●In a situation analogous to
the carbohydrate choices, plant-
based proteins have been added
to the Meats and Meat Substi-
tutes Group. While they are sim-
ilar to meats in that, per serving,
they have ⬃7 g protein, they
have carbohydrate as well. For
example,
3
⁄
4
oz soy nuts is
“counted as”
1
⁄
2
carbohydrate⫹1
medium-fat meat.
5. If foods in the Free Foods List are
consumed often in 1 day (particu-
larly those with amounts listed),
the calories and carbohydrates
consumed could affect expected
clinical outcomes.
6. Because many adults with diabe-
tes do consume alcohol, an alcohol
equivalents list has been included,
with each equivalent representing
100 calories of absolute alcohol. If
adults choose to drink alcohol,
they should be cautioned to con-
sume one drink or less/day for
women, two drinks or less per day
for men. A “drink” is defined as 12
oz beer, 5 oz wine, or 1
1
⁄
2
oz of
distilled spirits (5). Because alco-
hol does not readily interchange
with other food groups, the follow-
ing guidelines can be used:
●Because alcohol does not require
insulin to be metabolized, it
should not be counted in the
meal plan if used occasionally.
●If used daily, the meal plan cal-
orie level should be adjusted ac-
cordingly.
●Any carbohydrate taken with
the alcohol (mixed drinks) needs
to be counted.
Determining Food List Choices for Food
Label Nutrition Facts or Recipes
Using information from food labels
helps individuals to include favorite
foods in their meal plans, and every-
one uses favorite recipes at one time
or another for meal planning. While
the Choose Your Foods booklet con-
tains a simple method that people can
OF PROFESSIONAL INTEREST
886 May 2008 Volume 108 Number 5

use to convert recipes/nutrition facts
to food list choices, the information in
Figure 2 can be used as a guide to
increase the accuracy of the analysis.
The booklet also includes a sample
food label. Of particular interest is
the guidance for how to handle di-
etary fiber and sugar alcohols, as they
are incompletely digested, absorbed
and metabolized (16). Grams of sugar
alcohol (polyols) and dietary fiber are
included on the Nutrition Facts panel
of a food label; however, in deriving
energy value for food labeling, they
are calculated as having about half
the energy (2 kcal/g) of most other
carbohydrates (4 kcal/g). The Insti-
tute of Medicine indicates that less
energy is recovered from fiber than
the 4 kcal/g that is recovered from
carbohydrate, with the range being
1.5 to 2.5 kcal/g (17). The energy yield
of sugar alcohols ranges from 0.2
kcal/g (erythritol) to 3.0 g (hydroge-
nated starch hydrolysates) (18), and
averages about 2 kcal/g. Adjustment
is practical only if the amount per
serving of either dietary fiber or sugar
alcohols is ⬎5 g. In that case, count-
ing only half of the carbohydrate
grams from these food ingredients/
components would be useful when
calculating exchanges/food choices for
food labels or recipes and for individ-
uals who are using insulin-to-carbo-
hydrate ratios for managing their di-
abetes.
CONCLUSIONS
The fifth revision of this booklet contin-
ues to provide a structure for choosing
foods for diabetes and weight-manage-
ment meal planning. Based on a survey
of registered dietitians and other
health professionals, current diabetes/
nutrition recommendations, and cur-
rent marketplace foods, many changes
Steps Suggestions
1. Determine what list(s) to use
as choices/servings
Use starch, fruit, milk, and nonstarchy vegetables lists when possible rather than the generic
“carbohydrate.” This helps in planning healthy meals.
If there are substantial amounts of carbohydrate from three or all four of the
abovementioned lists, if the serving has ⱖ1/3 of the carbohydrate as added sugars, or if
the food is a dessert-type food, simply call the choice “carbohydrate.”
Occasionally a solution will include both a specific carbohydrate list and a general
carbohydrate serving (eg, one starch⫹
1
⁄
2
carbohydrate).
2. Adjust carbohydrate grams if
needed
If a food contains ⬎5 g sugar alcohols or dietary fiber, subtract half the grams of sugar
alcohols or fiber from the carbohydrate grams to get the total adjusted carbohydrate
grams (16).
3. Use rounding to determine
the approximate number of
choices
For carbohydrate, use 15 g per choice for starch, fruit, sweets; 12 g per choice for milk; 5 g
per choice for nonstarchy vegetables. Actual carbohydrate per serving should be within
⫾5 g of choice determination. Range and rounding guidelines:
ⱕ5 g: do not count
⬎5toⱕ10 g:
1
⁄
2
choice/serving
⬎10 to ⱕ20: 1 choice/serving
For protein, use 7 g per choice for meats/meat substitutes. Actual protein per serving should
be within ⫾3 g of choice determination. Range and rounding guidelines:
ⱕ4 g: do not count
⬎4toⱕ10 g: 1 choice/serving
For fat, use 5 g/choice. Actual fat per serving should be within ⫾2 g of the choice
determination. Range and rounding guidelines:
ⱕ2: do not count
⬎2toⱕ4g:
1
⁄
2
choice/serving
⬎4toⱕ7 g: 1 choice/serving
The actual energy value per serving should be within ⫾20 calories of the total choice
determination value.
Do not use
1
⁄
4
or 1/3 choices, and do not use
1
⁄
2
vegetable or
1
⁄
2
meat exchanges. Half
choices for starches, fruits, milk, or carbohydrate can be more easily used in meal
planning.
4. Prioritize Give carbohydrate grams first priority, protein second, and fat third. The calories will usually
fall into the acceptable level if the other figures are correct.
Milk and vegetables are sometimes hard to include in adequate amounts in a meal plan.
Make an effort to include even half amounts of milk. Designating a recipe or Nutrition
Facts label as having three or four nonstarchy vegetable choices (5 g carbohydrate each),
given that the vegetables are truly available in the food, would be appropriate.
5. Make adjustments if needed,
particularly for main dishes
or meals
No food group is represented completely by one nutrient (eg, the carbohydrate group foods
contain small amounts of fat and protein, see the Table). For example, three starches
could have up to9gofprotein, which will reduce the number of meat choices by one;
two lean meat choices may have up to 5-6 g fat, which will reduce the number of fat
choices by one.
Figure 2. Suggestions for converting label Nutrition Facts or recipe servings into food list choices/servings.
OF PROFESSIONAL INTEREST
May 2008 ●Journal of the AMERICAN DIETETIC ASSOCIATION 887

were made, including title change and
design; however, it retains the vali-
dated system of dividing foods into
groups (starches, fruits, milks, non-
starchy vegetables, meats and fats).
Thus, this booklet can be used as a
resource for people with diabetes, a
method for assessing food intake, a
base for developing/revising other meal
planning publications (eg, carbohy-
drate counting, weight management),
and a method for college students, die-
tetic interns, diabetes health profes-
sionals, and others to learn about dia-
betes meal planning. Choose Your
Foods: Exchange Lists for Diabetes,as
well as companion publications (Span-
ish version, Choose Your Foods: Ex-
change Lists for Weight Management)
may be purchased from the online
stores of the American Dietetic Associ-
ation (http://www.eatright.org,ac-
cessed April 4, 2008) or the American
Diabetes Association (http://www.
diabetes.org, accessed April 4, 2008).
Development of this edition of the
booklet, as with almost all previous
editions, has been supported by the
American Dietetic Association and
the American Diabetes Associations
(survey and analysis, staff support,
conference calls, editing, and publica-
tion). The writing group received no
financial support for revising this
booklet.
The authors thank Abe Ogden, As-
sociate Director, Book Publishing,
American Diabetes Association, for
his skill as an editor and his assis-
tance in coordinating “all the pieces,”
and Diana Faulhaber, Publisher,
American Dietetic Association, and
Victor van Beuren, Professional Book
Acquisitions, American Diabetes As-
sociation, for their support through-
out this project. The authors also ac-
knowledge Lawrence A. Wheeler,
MD, PhD, Nutritional Computing
Concepts, for his expertise in extract-
ing the database and providing statis-
tical assistance.
References
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