503060

Using the Food Exchange List
The Food Exchange Lists are as follow:

Food Exchange List.
Vegetable A: 1 exchange contains negligible amounts of energy, CHO and CHON. 2 exchanges of this group
would be equivalent to 1 exchange of vegetables from Vegetable B group
Vegetable B List, Fruit Exchange, Milk Exchange, Sugar Exchange,, Rice Exchange, Meat, Poultry and Fish
exchange List, Fat Exchange.
Before you could start using the FEL, one must first determine the desirable body weight of the person, energy
allowance, suited to the activity level of the person, and the diet prescription.
STEP 1: DESIRABLE BODY WEIGHT (DBW), ALSO REFERRED TO AS REFERENCE, IDEAL OR
STANDARD BODY WEIGHT.
Tanhauser’s or Broca Method
Steps Example
1. Express height in centimeters: 1 inch = 2.54 cm 1. Given: adult female, height=5’2” Ht (cm)
=62 inches x 2.54 cm/inch = 157.48 cm
2. Subtract the factor 100 from the height in cm to get 2. DBW (kg) = 157.48-100
the DBW in kg = 57.48 cm
3. Adjust the DBW to the Filipino stature by deducting 3. DBW: 57.48 – 5.748
10% from the DBW. = 51.73
4. Get the DBW weight range by subtracting and 4. DBW weight range
adding 10% of the value. 51.73-5.173 = 46.56
51.73 + 5.173 = 56.90
5. Round off the weights to the nearest whole number 5. DBW = 52 kg
DBW Range = 46-57 kg
6. DBW = 114 lbs
Range : 101-125 lbs
6. You may express the kg in lbs: 1 kg = 2.2 lbs
STEP 2: TOTAL ENERGY ALLOWANCE (TEA)
Determine a reasonable allowance by multiplying his DBW with the following values:
Kcal/kg/DBW
Activity
Bed rest but mobile (e.g. hospital patients ) 27.5
Sedentary (mostly sitting e.g. clerical work, student) 30
Light (e.g. tailor, nurse, physician, jeepney driver) 35
Moderate (e.g. carpenter, painter, heavy housework) 40
Very Active (e.g. lumberman, swimming) 45
Note: Total Energy Allowance is rounded off to the nearest number divisible by 50 for ease of computations.
STEP 3: ESTIMATE ENERGY FROM CHO, CHON, AND FAT

Determine the CHO, CHON, and fat of the diet. Carbohydrates, protein and fat all contribute energy (kcal) to the
ldiet. The following are recommended caloric percentages for these energy-giving nutrients. The percentage
levels will depend on the diet prescription or the usual food habits of the person.
Energy-yielding Nutrients Percentage of TEA Customary %
55-70 65
Carbohydrates
Protein 10-15 15
Fat 20-30 20
For classroom purposes, the customary percentage distribution will be used.
STEP 4: EXPRESSING ENERGY CONTRIBUTIONS IN GRAMS
In expressing energy contributions of CHO, CHON, and fat into grams of each of these nutrients use the
following equivalents in doing your computations.
Energy-yielding Nutrients Physiologic Fuel Value
Carbohydrates 1 g CHO = 4 kcal
Protein 1 g CHON = 4 kcal
Fat 1 g fat = 9 kcal
STEP 5: WRITE THE DIET PRESCRIPTION
Write the diet prescription observing the following:
 Round off total Energy needs to the nearest number divisible by 50
 Round off CHO, CHON, and fat to the nearest number divisible by 5.
STEP 6: TRANSLATE THE DIET PRESCR
IPTION INTO EXCHANGES
Allocate exchange allowances for the different exchanges based on the following guidelines.
 It is desirable to allow 2-3 exchanges for Veg A and B per day.
 3-4 exchanges of fruit per day is recommended unless restriction is required.
 Milk allowances depend on the patient’s needs, food habits and other economic considerations.
 5-9 teaspoons of sugar exchanges may be allowed per da’
 y unless contraindicated.
Example: after allotting the number of exchanges for Veg A and B, fruit, milk, and sugar ( taking into
consideration the person’s food habits), write the corresponding amounts of CHO, CHON, fat and energy (refer
to Table A) for the given number of exchanges of these food groups. Compute for CHO subtotal.
Compute for the number or rice exchanges:
Subtract the CHO subtotal from the prescribed CHO to get the CHO from rice. Express grams of CHO from
rice into exchanges.
Recall: 1 rice exchange = 23 g CHO
Compute for the number or meat exchanges:
Subtract the CHON subtotal from the prescribed CHON to get the CHON from meat
Express the grams of protein into exchanges
Recall: 1 meat exchange = 8 grams of CHON
Round off exchanges to the nearest whole number
Make the necessary entries for the meat exchange in the table. Distribute meat exchanges among the low,
medium and high fat meat groups. Allocation
of the exchanges will depend on the food habits and diet restrictions of the individual. Planning for the meat
exchanges would be easier if one is familiar
with the foods in the different meat groups.
Compute for the number or fat exchanges:
Express grams of fat into exchanges
Recall: 1 fat exchange = 5 grams of fat
Round off exchanges to the nearest whole number
Make the necessary entries for Fat exchanges in the table
Total the CHO, CHON, and Energy values for all the food groups.
Compare the Total values that you got with the diet prescription.
Degree of acceptability: Diet Rx + 5 for the macronutrients
Diet Rx + 50 for the Total Energy
Note: If your values exceed the allowed range, you must adjust the values by decreasing the number
of exchanges of sugar or fruit (if CHO values exceed), meat (if CHON values exceed) or fat (if fat values
or Total energy exceeds).
STEP 7: DISTRIBUTE EXCHANGES INTO THE DIFFERENT MEALS FOR ONE DAY.
FEL Values
Food List Exch Measu CHO CHO Fat Kcal Distribution of exchanges
re N
B AM L PM S MS
Veg A 1 1 cup (1.5) (0.5) (8)
raw
2 2 cups 3 1 16
raw
Veg B 1 2 c raw 3 1 16
Fruit 1 Varies 10 40
Milk (specify 1 Varies 12 8 10 170
kind
W
LF 1 Varies 12 8 5 125
1 Varies 12 8 tr 80
Skimmed
Sugar 1 Varies 5 20
Rice 1 Varies 23 2 100
Meat (Low 1 Varies 8 1 41
fat
Meat (Med 1 Varies 8 6 86
fat)
Meat (High 1 Varies 8 10 122
fat)
Fat 1 Varies 5 45
Total

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Using the Food Exchange List

The Food Exchange Lists are as follow:

STEP 3: ESTIMATE ENERGY FROM CHO, CHON, AND FAT

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