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Teaching Carbohydrate Exchanges

Medical  nutrition therapy is an integral part of diabetes management. I am not a dietitian but I do try to teach my patients the diabetic exchange system. A formal diet plan by the dietitian includes a computation for how many carbohydrate exchanges or servings are allowed. In my clinic however, I just advise patients to keep to one cup of rice per meal and to take am and pm snacks equivalent to half a cup of rice.

How does that work out?

1/2 cup of rice = 1 cup noodles = 2 slices pan amerikano = 3 pieces pandesal = 1/2 cup oatmeal

So I tell my patient, if you’d rather eat pandesal in the morning – one cup of rice is equal to 6 pieces of pandesal. Of course I mean the P2 pandesal, the small ones. I used to say the P1 kind until a patient told me, “Dok, wala na pong pisong pandesal ngayon!”  But if the pandesal is for merienda, then only 3 pieces is allowed. If the patient prefers sliced bread, then he can have 4 slices for breakfast. One cup of rice is equal to one cup of oatmeal. There is a misconception that since oatmeal has fiber, you can eat as much as you want.

If for lunch, the patient would rather eat bihon, then 2 cups of bihon is equal to 1 cup of rice.

Dr. Philip Chua wrote about the calories in Filipino food. Check out this link if you’d like more information.

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