Starch

The Starch food list covers a variety of different starchy foods. This is the list where you’ll find foods that will have the greatest impact on your blood glucose. Whole grains (such as brown rice, oats, and quinoa), pastas, cereals, bread products, many desserts, and crackers, pretzels, and other starchy snacks can all be found on the Starch list. Starchy vegetables, such as potatoes, corn, green peas, beans, acorn squash, and pumpkin, are included in this list because they are higher in carbohydrate than nonstarchy vegetables.

When choosing foods from the Starch list, remember that starchy vegetables, whole grains, and beans (which contain vitamins, minerals, and fiber) are more nutritious choices than processed, refined starches such as white breads and pastas, and sugary desserts.

Starchy foods that are prepared with fat, such as baked goods or starchy vegetables, count as one Starch choice and one Fat choice.

One Starch choice contains 15 grams of carbohydrate, 3 grams of protein, 1 gram of fat, and 80 calories. Generally speaking, one Starch choice is equal to

• ½ cup of cooked grains or starchy vegetables
• ⅓ cup of cooked rice or pasta
• 1 ounce of bread (bread products that are larger than 1 ounce will equal more than one choice)
• ¾–1 ounce of starchy snack foods

Fruits

The Fruits list covers all types and preparations of fruit, including fresh, frozen, dried, and canned fruits and fruit juices. When you purchase canned fruits, you’ll notice that there are several types of canning liquids used: juice, light, syrup, and heavy syrup. All the canned fruits on the Fruits list are either “no sugar added,” “juice pack,” or canned in extra-light syrup. All three of these options have a similar amount of carbohydrate, and they’re the best canned fruit options for people with diabetes. Fruits canned in heavy syrup should be avoided.

One Fruit choice contains 15 grams of carbohydrate, 0 grams of protein and fat, and 60 calories. In terms of portion sizes, one Fruit choice is the equivalent of

• ½ cup of canned or frozen fruit
• 1 small piece of fresh fruit
• ½ cup of fruit juice (unsweetened)
• 2 tablespoons of dried fruit

Some of the whole fresh fruits on the Fruits list are measured by weight (rind and seeds included) instead of cups or tablespoons. It’s a good idea to weigh your fresh fruits using a food scale to get an idea of the size of your favorite fruits and how that relates to the number of choices you’ll be eating. Fruits are full of beneficial nutrients, but they also contain carbohydrate, so serving size matters!

Milk and Milk Substitutes

The Milk and Milk Substitutes list includes a variety of different milk options, including rice and soy milks and yogurt. But not all dairy products are included on this list; you’ll find items like cheese, butter, cream, nut milks, and ice cream on other food lists because they contain minimal carbohydrate and, therefore, don’t impact your blood glucose like milk and milk substitutes will.

The best Milk and Milk Substitute choices for people with diabetes are usually lower-fat varieties such as fat-free or low-fat milk, or low-fat or nonfat yogurt.

One Milk/Milk Substitute choice contains 12 grams of carbohydrate and 8 grams of protein. The fat and calorie content varies among the items on this list. For example:

• Fat-free or low-fat choices contain 0–3 grams of fat and about 100 calories per serving
• Reduced-fat or 2 percent choices contain 5 grams of fat and 120 calories per serving
• High-fat or whole-milk choices contain 8 grams of fat and 160 calories per serving

Pay close attention to the fat content and serving size of the foods you choose from this list so you don’t consume more carbohydrate, fat, and calories than you intend to.

Nonstarchy Vegetables

This food list is made up of raw, canned, and cooked nonstarchy vegetables including tomatoes, onions, mushrooms, broccoli, carrots, spinach, summer squash, and zucchini (to name just a few). Because they’re higher in carbohydrate and calories, starchy vegetables such as corn, green peas, potatoes, and winter squash are included in the Starch list.

Nonstarchy vegetables are an important part of a diabetes-friendly meal plan, and you should aim to eat several servings of these vegetables each day. If you choose canned vegetables or vegetable juice, look for no-salt-added or low-sodium options. If you can’t find low-sodium canned vegetables, drain and rinse them before use to reduce their sodium content.

One Nonstarchy Vegetable choice contains 5 grams of carbohydrate, 2 grams of protein, 0 grams of fat, and 25 calories. In general, one Nonstarchy Vegetable choice equals

• ½ cup of cooked vegetables
• 1 cup of raw vegetables
• ½ cup of vegetable juice

Nonstarchy vegetables are low in carbohydrate and can be enjoyed in relatively large quantities. However, if you decide to eat three Nonstarchy Vegetables choices (3 cups of raw vegetables or 1½ cups cooked vegetables or more) in a single meal, you should count them as one Carbohydrate choice instead.

Sweets, Desserts, and Other Carbohydrates

The Sweets, Desserts, and Other Carbohydrates list includes carbohydrate-rich foods that do not have the same nutrient makeup as the foods in the Starch list. This list contains a wide variety of food items including sodas, sports drinks, and other beverages; cakes and cookies; candies and sweeteners; condiments; pastries; and frozen desserts. People with diabetes should select foods from this list less often than other carbohydrate-containing foods such as starches, fruits, and nonstarchy vegetables — all of which contain more fiber and beneficial nutrients than foods on the Sweets, Desserts, and Other Carbohydrates list.

One choice from the Sweets, Desserts, and Other Carbohydrates list (called a Carbohydrate choice) contains 15 grams of carbohydrate and 70 calories. In terms of their carbohydrate, fat, and calorie content, the foods on this list vary widely. In fact, many of the foods on this list contain more than a single Carbohydrate choice, and some include Fat choices as well (one Fat choice is equal to 5 grams of fat and 45 calories).

The Sweets, Desserts, and Other Carbohydrates list specifies how many choices each food contains per serving, so don’t worry! You won’t have to figure this out on your own.

Protein

The Protein list covers all kinds of protein foods, not just meats, poultry, and fish. Eggs, cheese, and plant-based proteins are also included in the list due to their high protein content. Foods on the Protein list are divided into four groups based on their fat content: lean protein, medium-fat protein, high-fat protein, and plant-based protein. The nutrients in a Protein choice vary based on the type of protein. For example:

• One lean Protein choice contains 0 grams of carbohydrate, 7 grams of protein, 2 grams of fat, and 45 calories.
• One medium-fat Protein choice contains 0 grams of carbohydrate, 7 grams of protein, 5 gram of fat, and 75 calories.
• One high-fat Protein choice contains 0 grams of carbohydrate, 7 grams of protein, 8 grams of fat, and 100 calories.
• One plant-based Protein choice contains 7 grams of protein just like the other Protein choices, but the amounts of carbohydrate, fat, and calories vary depending on the specific food item. (Note that veggie and soy burgers and other meat substitutes may contain a significant amount of carbohydrate.)

The best animal Protein choices for people with diabetes are lean meats. Look for lean cuts of meat and poultry when shopping; they contain less saturated fat and cholesterol than higher-fat proteins, such as processed meats and prime cuts.

Don’t forget to watch your portion sizes with proteins! The serving sizes given in the Protein list are based on the cooked weight of the protein after bones and excess fat have been removed.

Fats

Like the Protein list, the Fats list is divided into subgroups as well. But in this case, the groups are based on the type of fat the foods contain, not the quantity of fat. These three groups are

• Unsaturated fats, which primarily come from plant sources such as nuts and seeds.
• Saturated fats, which primarily come from animal sources and should be consumed in moderation.
• Trans fats, which are a product of food processing; these fats should be avoided.

One Fat choice contains 5 grams of fat and 45 calories, and one choice is equal to approximately

• 1 teaspoon of oils or solid fats
• 1 tablespoon of salad dressing

For the most nutritious fat options, try to choose sources of unsaturated fat from this list over saturated and trans fats whenever you can, and use liquid fats instead of solid fats when cooking.

You may be surprised to see nuts and seeds on the Fats list, but they’re a good source of unsaturated fats and contain other beneficial nutrients. Keep in mind, though, that all fats, even unsaturated fats, should be eaten in moderation because they’re high in calories. So keep an eye on your portion sizes.

Free Foods

A free food is defined as any food (or beverage) that contains less than 20 calories and 5 grams of carbohydrate or less per serving. Free foods shouldn’t have a significant effect on your blood glucose levels, and you don’t need to account for these foods in your meal plan. You’ll see a wide variety of foods on this list, from chewing gum and sugar substitutes to reduced-fat mayonnaise and salad dressings to salad greens and small servings of nonstarchy vegetables.

Many of the food items on the Free Foods list have serving sizes, while others don’t. Why is that? If a free food is listed with a serving size, it means that the calories and/or carbohydrate in that serving size are close to the limits for a free food. Avoid eating more than three servings of that food per day, and if you choose to eat all three of those servings at once, count them as one Carbohydrate choice. Foods on the Free Foods list without a serving size can be enjoyed at any time.

Combination Foods

Using food choices is simple when you’re eating individual foods, but maybe you’re wondering where your favorite casserole, soup, or frozen meals fits into this meal-planning method. How do you figure out the choices for foods that are a combination of starches, proteins, fruits or vegetables, and fats? These “combination foods” don’t fit clearly into any one food list.

Fortunately, the booklet Choose Your Foods: Food Lists for Diabetes provides a Combination Foods list to help with this situation. This list gives the serving size and choices for some typical combination foods that you may encounter, including casseroles, stews and soups, frozen meals, and pizza.

If you have favorite combination foods that you prepare at home using your own recipes, the nutrients of those dishes may differ from the information presented in the Combination Foods list. It may be worth doing a little math to figure out the nutrient content of your recipe and find the appropriate exchanges. Your dietitian should be able to help you with this if you bring the recipe to an appointment, or you can work this out on your own following these steps:

1. Find the amount of calories, carbohydrate, protein, and fat in each ingredient.
2. Add up the total amount of calories and the total amount of each other nutrient for the recipe.

3. Divide the total amount of calories and the totals for the other nutrients by the number of servings in the dish.

   This will give you the nutrients for each serving.

4. Compare the nutrients per serving with the definitions of Carbohydrate, Protein, and Starch choices to determine the choices per serving.

Fast Foods

Healthy eating doesn’t stop when you’re on the go! If you’re having a busy day and need to stop at a fast-food restaurant for a meal, you can use the Fast Foods list to work that meal into your meal plan. The choices in this list don’t represent specific fast food menu items; instead they’re estimated based on popular fast-food items. For example, you won’t find the choices for a four-piece fried chicken meal from your favorite fast-food restaurant, but you will find entries for breaded and fried chicken breasts, thighs, wings, and drumsticks.

The Fast Foods list is a great starting point, but if you want the nutrition information for menu items at a specific restaurant, they should be available online.