Thus, it may be said that both a low Fat Portion exchange system of 1989 and a low fat Mediterranean food exchange list (2014) were equally successful and ended up with the consensus that it is a useful dietary tool for improvement of diet quality and could be used for achieving positive outcomes for intervention.19
The food exchange list is being used as a means of providing medical nutritional therapy to diabetics20 since 1950 and its fifth revision came with a new title of Choose Your Foods: Exchange List for Diabetes.10 This tool was designed to assist in translating evidence based nutrition recommendations into healthful eating choices11 and distributing carbohydrate intake during the day into five to seven small to moderate meals and snacks21 reducing HbA1c levels in individuals with type 2 diabetes.20
Besides the ADA Food Exchange List10 a 10 g protein counter (EP-10) was also developed to expedite the estimation of dietary protein for nutritional assessment and recommendation and it was seen that both EP-10 and ADA-7g are valid clinical tools for protein intake21 A Food Exchange List was also fashioned for renal patients living South Africa24 and for those belonging to Southeast Asian origin.
Use of the standard Food Exchange list for the treatment and management of diabetes showed limitation as it was cultural insensitivity and modification to the standard food exchange list was done by addition of local foods so that it could be used in Central America.7
Food Exchange List is an appropriate tool for effective nutrition education, intended for improving nutrition knowledge, attitudes and dietary behaviors both at an individual and community level.26 However, to ensure that this tool is more effective cultural variations will have to be taken into consideration so as to provide the user with food items with which he or she is more familiar as exact menus and food amounts are a prerequisite to ascertain nutrient adequacy of any dietary regime.27
Improved Quality of Food Exchange List and Adherence to Specific Diets: Dietary Tools that are reassessed and modified to cater new demands have proved to be more effective in relevance to NCD management.
Diets planned from updated and locally relevant FELs have the benefit of greater acceptance with better chance of being implemented with success, thus aiding elimination of adherence related issues such as limited food items in the food exchange list, fewer options and unrealistic portion sizes.24
The food exchange list is effective for managing chronic non-communicable diseases, for which dietary modification is a corner-stone of treatment.
Differences between analyzed and estimated sodium contents of food composition table or food exchange list. J Korean Soc Food Sci Nutr.
This review focuses at highlighting the importance of Food Exchange List in cultural perspective, as an effective dietary tool to help individuals' manage their dietary modifications in relation to non communicable diseases whilst specifying measures that can help improve the quality of Food Exchange Lists for combating various non communicable diseases and addressing adherence related issues to specialized diets.
Out of the 837 papers accessed 57 were identified as relevant to the Food Exchange List, out of which 39 papers were focused to the concept and development of the Food Exchange List.
The text includes clinical applications, cultural dietary considerations, chapter review questions with an answer key, nutritional summary charts, food exchange lists
for diabetes, measurement conversion tables, and a glossary.