Eating Disorder Meal Planning with Exchanges

Are you recovering from an eating disorder, planning out your meal plan exchanges and wondering where to begin? We can help! Ideally, your meal plan should be a balanced healthy daily meal plan that has been customized by a Registered Dietician. However we must educate ourselves on what is going into our bodies, especially because a dietician can only help so much- they don’t help us actually prepare our meals!

Knowing how to design your own meal plan may help you as you move forward with your recovery by empowering you to make healthy meal choices, because ultimately you get to choose whether or not you actually follow your daily food plan.

We have listed each food group with the corresponding exchanges to help you make healthy food choices!

This nutrition exchange system is based on six main food groups: Vegetables, Fruits, Proteins, Starches (carbohydrates), Fats, and Milk (dairy or alternatives). A good thing to remember is that meal planning is not an exact science, even though when planning your eating disorder meal plan you will want it to be! It is more of an art and you should remember “close enough is good enough.” When you are first learning this exchange system, you should measure or weigh the amount of food specified for each meal. Then when you have a basic understanding you can simply estimate portion sizes. For more help on visualizing portion sizes click here. Go here for sample eating disorder meal plans.

Here are meal plan exchanges for eating disorders that your daily food plan will be based on. This list is based on “Exchange Lists for Meal Planning” from the American Dietetic Association and the American Diabetes Association.

1 serving=1 exchange

Carbohydrate List

Cereals, grains, pasta, breads, crackers, snacks, starchy vegetables, and cooked beans, peas and lentils are starches. One exchange of bread typically contains 15 gram of carbohydrates, 3 grams of protein, 0-1 fat and 80 calories. Whole grain products contain about 2 grams of fiber or more per serving.

In general, 1 starch is:

½ cup of cooked cereal, grain, or starchy vegetable
½ cup of cooked rice or pasta
1 oz of a bread product, like 1 slice bread
¾ to 1 oz of most snack foods

Your eating disorder meal plan will probably include about 6-8 carbohydrate exchanges per day (check with your dietitian).

Examples of Starches, Portions, and Number of Exchanges:

Breads

Bagel ½ bagel = 1 exchange
Bread – whole wheat 1 slice = 1 exchange
Bun – hamburger, hot dog 1 bun = 2 exchanges
English muffin 1 muffin = 2 exchanges
Pancake- 4 inch across, ¼” thick 1 exchange
Pita Bread pocket – 6 in across ½ pita = 1 exchange
Roll – dinner roll, hard roll 1 small (2 in square)
Tortilla – 6 in across 1 tortilla = 1 exchange
Waffle – 4 inch square 1 exchange

Cereals & Grains

Cooked cereal – oatmeal, cream of wheat ½ cup cooked = 1 exchange
Dry Cereal (read box) ½ to ¾ cup = 1 exchange
Couscous 1/3 cup = 1 exchange
Pasta ½ cup = 1 exchange
Rice – white or brown ½ cup = 1 exchange
Wheat germ 3 Tbsp = 1 exchange

Starchy Veggies

Baked beans/refried beans 1/3 to ½ cup = 1 exchange
Peas ½ cup cooked = 1 exchange
Corn ½ cup cooked or 6 inch on cob = 1 exchange
Potato/Yam/Sweet Potato ½ cup mashed or small 3 oz potato = 1 exchange
Winter squash 1 cup = 1 exchange

Crackers and Snacks

Graham crackers 3 squares = 1 exchange
Saltine crackers 6 crackers = 1 exchange
Popcorn 3 cups = 1 exchange
Potato chips/tortilla chips 10 chips = 1 exchange
Pretzels ¾ oz hard/10 mini/2 rods = 1 exchange
Rice Cakes – 4 in across 2 cakes = 1 exchange
Whole wheat crackers 2-5 crackers (3/4 oz) = 1 exchange

Beans, Peas, and Lentils

Beans and peas (garbanzo, pinto, kidney, white, split, black-eyed) 1/3 cup = 1 starch or 1 protein
Lima beans 1/3 cup = 1 starch or 1 protein
Lentils 1/2 cup = 1 starch or 1 protein

Starchy Foods Prepared with Fat

Biscuit – 2 ½ in across 1 biscuit = 1 starch plus 1 fat exchange
Chow mein noodles ½ cup = 1 starch plus 1 fat exchange
Corn bread – 2 in cube 2 oz cube = 1 starch plus 1 fat exchange
Crackers round butter type 6 crackers = 1 starch plus 1 fat exchange
Croutons 1 cup = 1 starch plus 1 fat exchange
French fried potatoes (baked) 1 cup (2 oz) = 1 starch plus 1 fat exchange
Granola ¼ cup = 1 starch plus 1 fat exchange
Hummus 1/3 cup = 1 starch plus 1 fat exchange
Muffin – 5 oz 1/5 (1 oz) = 1 starch plus 1 fat exchange
Popcorn, microwaved 3 cups = 1 starch plus 1 fat exchange
Sandwich crackers – cheese or peanut butter filling
3 crackers = 1 starch plus 1 fat exchange
Snack chips – potato/tortilla 9-13 (3/4 oz) = 1 starch plus 1 fat exchange

Fruit List

One fruit exchange equals 15 grams of carbohydrate and 60 calories. Fruits include fresh, frozen, canned and dried fruits.

Typically, 1 fruit exchange is:

1 small (4 oz) fresh fruit
½ cup of fresh fruit or canned (make sure to rinse!)
½ cup unsweetened fruit juice
¼ cup of dried fruit

Weight listed below includes skin, core, seeds, and rind. Your eating disorder meal plan will probably include about 2-5 fruit exchanges per day (check with your dietitian).

Examples of Fruits, Portions, and Number of Exchanges:

Apple 1 small = 1 exchange
Applesauce-unsweetened ½ cup
Apricots – fresh 4 whole (5 ½ oz) = 1 exchange
Apricots – dried halves 8 = 1 exchange
Banana – small 1 (4 oz) = 1 exchange
Blackberries ¾ cup = 1 exchange
Blueberries ¾ cup = 1 exchange
Cantaloupe – small 1/3 melon or 1 cup cubed = 1 exchange
Cherries – fresh 12 (3 oz) = 1 exchange
Dates 3 = 1 exchange
Fruit cocktail ½ cup = 1 exchange
Grapefruit – large ½ grapefruit = 1 exchange
Grapes – small 17 (3 oz) = 1 exchange
Kiwi 1 (3 ½ oz) = 1 exchange
Mandarin oranges, canned ¾ cup = 1 exchange
Nectarine 1 (5 oz) = 1 exchange
Orange – small 1 (6 ½ oz) = 1 exchange
Peach – medium, fresh 1 (4 oz) = 1 exchange
Pear – large, fresh ½ (4 oz) = 1 exchange
Pineapple – fresh ¾ cup = 1 exchange
Plums – small 2 (5 oz) = 1 exchange
Plums – dried (prunes) 3 = 1 exchange
Raisins 2 Tbsp = 1 exchange
Raspberries 1 cup = 1 exchange
Strawberries 1 ¼ cup whole berries = 1 exchange
Watermelon 1 slice (13 ½ oz) or 1 ¼ cup cubes = 1 exchange

Milk List

One milk exchange equals 12 grams of carbohydrates and 8 grams of protein. Cheeses are in the protein list and other dairy fats are on the fats list.

Your eating disorder meal plan will probably include about 1-3 dairy exchanges per day (check with your dietitian).

Examples of Milk Items, Portions, and Number of Exchanges:

Milk- skim or 1% 1 cup (8 oz) = 1 exchange
Soy milk – low fat or fat free 1 cup = 1 exchange
Yogurt – fat free or light 2/3 cup (6 oz) = 1 exchange

Protein List

One protein exchange equals 7 grams of protein, 5 grams of fat and 75 calories. Meats should be weighed after cooking, allowing for bone and meat.

In general,

1 oz meat = 1 protein exchange

Your eating disorder meal plan will probably include about 6-8 exchanges per day depending on your situation, weight, age, etc. (Make sure to check with your dietician).

Examples of Protein Foods, Portions, and Number of Exchanges:

Poultry

1 oz meat = 1 exchange
Chicken, turkey, Cornish hen and guinea hen
Chicken (with skin), domestic duck or goose and ground turkey

Fish & Shellfish

Any fresh or frozen fish 2 oz = 1 exchange
Salmon (canned or fresh) 2 oz = 1 exchange
Sardines, medium (canned) 2 = 1 exchange
Crab, lobster, scallops and shrimp 2 oz = 1 exchange
Tuna ¼ cup = 1 exchange
Any fried fish product 1 oz = 1 exchange

Beef

1 oz meat = 1 exchange
Baby beef, chipped beef, flank steak, tenderloin, plate skirt steak, round (all cuts), rump, spare ribs, and tripe
Ground beef (all), roast (rib chuck and rump), steak (cubed, porterhouse, and T-bone), and meatloaf
Most USDA prime rib cuts (ribs and club steak), corned beef and brisket

Pork & Veal

1 oz meat = 1 exchange
Lean pork (fresh, canned, cured and boiled ham), Canadian bacon and tenderloin
Most pork products (chops, loin roast, cutlets)
Sausage (patty and link) and deviled ham
Veal -all cuts (leg, loin, rib, shank, shoulder and cutlet)

Cheese

1 oz = 1 exchange
All regular or low fat cheese (American, blue, cheddar, Monterey, Swiss, etc)
Cottage cheese (2%) ¼ cup = 1 exchange
Grated Parmesan cheese 2 Tbsp = 1 exchange
Ricotta ¼ cup = 1 exchange

Other

Egg w/yolk 1 egg = 1 exchange
Hot dog 1 oz = 1 exchange
Lunch meat 1 oz = 1 exchange
Peanut Butter 1-2 Tbsp = 1 exchange
Sausage 1 oz = 1 exchange
Tofu ½ cup = 1 exchange
Veggie Burger 1 patty (14 grams protein) = 2 exchanges

Vegetable List (Non- Starchy)

Typically, 1 vegetable exchange is

½ cup cooked vegetables or vegetable juice
1 cup raw vegetables

Your eating disorder meal plan will probably include about 3-5 vegetable exchanges per day (check with your dietitian).

Examples of Non-starchy Veggies:

Artichoke
Asparagus
Beans (green, wax, Italian)
Bean sprouts
Beets
Broccoli
Cabbage
Carrots
Cauliflower
Eggplant
Greens (collard, kale, mustard, turnip)
Kohlrabi
Leeks
Mixed vegetables (without corn, peas)
Mushrooms
Okra
Peppers
Radishes
Salad Greens (endive, escarole, lettuce, romaine, spinach)
Sauerkraut
Spinach
Summer squash
Tomato
Tomato sauce
Turnips
Water chestnuts
Zucchini

The Fats List

Your eating disorder voice may be screaming, “Fats! I don’t want to be fat or eat fats! I feel fat!!!” Truth is, our body needs some fats, especially good fats. Your dietitian should be able to tell you how much of this group that you need.

There are 3 types of fats: monounsaturated, polyunsaturated and saturated. Mono- and poly- unsaturated fats in the foods we eat are linked with good health benefits!

In general, 1 fats exchange=

5 grams fat and 45 calories
1 teaspoon of regular margarine or vegetable oil or 1 Tbsp light margarine/oil
1 Tbsp of regular salad dressing or 2 Tbsp reduced fat salad dressing

Your eating disorder meal plan will probably include about 0-5 exchanges per day depending on your needs: weight, exercise level, etc. (check with your dietitian).

Examples of Fats Items & Portions for 1 Exchange:

Mono-unsaturated and Poly-unsaturated Fats

Avocado, medium 2 Tbsp
Nuts – almonds, cashews, mixed 6 nuts
Nuts – walnuts, English 4 halves
Peanuts 10 nuts
Pecans 4 halves
Margarine 1 tsp
Mayo – regular 1 teaspoon
Mayo – reduced fat 1 Tbsp
Seeds – pumpkin, sunflower 1 Tbsp

Saturated Fats

Bacon – 1 slice
Butter – stick 1 tsp, whipped 2 tsp, reduced fat 1 Tbsp
Cream cheese – regular 1 Tbsp, reduced fat 1 ½ Tbsp
Sour cream – regular 2 Tbsp, reduced fat 3 Tbsp

Sweets, Desserts & Other Carbohydrates

One carbohydrate exchange equals 15 grams of carbohydrate or 1 starch or 1 fruit or 1 milk.

These foods can be substituted for other carbohydrate-containing foods in your meal plan, even though they contain added sugars or fat
When choosing these foods, include foods from the other lists to eat balanced meals!

Add/substitute these foods to your eating disorder meal plan at you or your dietitian’s discretion!

Examples of Food Items, Portions, and Number of Exchanges:

Brownie, small, unfrosted 2” square (about 1 oz) = 1 carbohydrate, 1 fat
Cake, unfrosted 2” square (about 1 oz) = 1 carbohydrate, 1 fat
Cake, frosted 2” square (about 2 oz) = 2 carbohydrate, 1 fat
Cookie or sandwich cookie with cream filling 2 small (about 2/3 oz) = 1 carbohydrate, 1 fat
Doughnut, plain cake 1 medium = 1 carbohydrate, 2 fats
Doughnut, glazed 1 medium = 2 carbohydrates, 2 fats
Granola or snack bar 1 bar = 1 carbohydrate
Honey 1 Tbsp = 1 carbohydrate
Ice cream ½ cup = 1 carbohydrate, 2 fats
Ice cream, low-fat ½ cup = 1 carbohydrate
Milk, chocolate, whole 1 cup = 2 carbohydrates, 1 fat
Spaghetti sauce ½ cup = 1 carbohydrate
Frozen Yogurt ½ cup = 1 carbohydrate, 0-1 fat

Combination Foods List

There are obviously many foods we eat that are mixed together in various combinations. These foods do not fit into any specific list, but have several different exchanges associated with them. I have listed a few here; if you have any questions for things on your meal plan that you are unsure of their exchanges, please let me know and I can look up a specific food for you.

Examples of Food Items, Portions, and Number of Exchanges:

Tuna noodle casserole, lasagna, spaghetti with meatballs, chili with beans 1 cup (8 oz) = 2 carbohydrates, 2 proteins
Chicken or tuna salad ½ cup (3 ½ cup) = ½ carbohydrate, 2 proteins, 1 fat
Pizza, cheese, thin crust ¼ of 12 inch (6 oz) = 2 carbohydrates, 2 meats, 1 fat
Frozen entrée dinner-type meal Generally 14-17 oz = 3 carbs, 3 proteins, 2 fats
Soups – Vegetable beef, chicken noodle, or other broth-type 1 cup = 1 carbohydrate

Free Foods List

A free food is any food or drink that contains less than 20 calories or less than or equal to 5 grams of carbohydrate per serving. You can add these to your meals but please use with moderation!!

Examples of Free Foods:

Broth
Nondairy creamer
Coffee
Unsweetened tea
Ketchup
Mustard
Hot sauce
Vinegar
Celery
Cucumber
Radishes
Onion
Salad greens
Hot peppers
Salsa
Horseradish
Sugar free jello
Cream cheese, fat free
Drink mixes, sugar free
Salad dressing, fat free or low fat
Sour cream, fat free or reduced fat
Miracle Whip, fat free or reduced fat
Nonstick cooking spray
Tea
Lemon juice
Pickles
Soy sauce
Seasonings & spices
Garlic