Wednesday, March 26, 2008

Remembering the "Free Food"

I was diagnosed with type 1 diabetes in 1990. Some of you who have been more recently diagnosed had an advantage over me--one of your first lessons in diabetes management was most likely carb counting. I learned to count my carbs and bolus accordingly at the same time as receiving my first insulin pump. That was in 2000, when I was 18. So what was it that I did for the ten years before that?

I used a little something many of us know--the Diabetes Exchange System. Bear in mind this was at least a little different than exchange rates for money. Mealtime flexibility was not exactly the norm, but you could exchange one type of food for another. Did you want three starches? Two starches and a fruit? Three fruits? The whole point of exchanges was never clear to me, as I was very young. I knew it meant I had to measure, count and weigh nearly everything that went into my mouth. I knew it was annoying--I can hear my mother's voice now, saying to my 11-year-old self, "That's an awfully BIG half-cup of ice cream." Or, "Did you weigh those Goldfish crackers before you put them in that bowl?"

Oh man, just look at that book in the picture. There was no pocket guide when I was growing up. The book had about the same dimensions as one of those black and white composition books you used to get in school all the time. The book's cover had a dark teal border and a center illustration of various foods. No fancy actual food pictures here.

Carb counting opened up a whole new door for me, and as someone setting off for college, it meant a lot to me. Everything previously "forbidden" suddenly had a chance. If I wanted to have a snack with 15g of carbs, it didn't matter as much whether it was the healthy fruit I was supposed to eat or the half a candy bar my hormonally wacky body craved. What I remember the most about the old exchange system is that I had a set number of foods that I had to eat at each meal, broken up into their basic varieties: starches, proteins, fruits, veggies, fats and the ever-fascinating "free foods".

It's the free foods that came into my mind today at the grocery store as I bought a package of sugar-free store-brand gelatin cups. One of the few free foods I ever found appealing as a little kid was Jello. I preferred orange or lime, but there were no pre-filled cups readily available to stuff into my Little Mermaid lunchbox. My mom would make it, put it some kind of small plastic container, and toss it in. Sometimes, like around a holiday or a birthday, I would opt to take a baggie of celery or cucumbers instead of my usual baggie of carrots so that I could also have a sliver of sugar-free pie or icingless cake with my sandwich and crackers.

That's really when the exchanges came into play. I never remember them being a big deal at the time, but looking back on it, I can definitely remember feeling trapped and guilty around food, especially as I got into my teens. Some kids use adolescence to experiment in sex, drugs, reckless behavior, or getting into fights with their parents. I remember sneaking Italian Ice Cups or extra potato chips in the school cafeteria. I'd pay for them, of course--I was a good kid after all.

The most recent list of free foods that I found on the Mayo Clinic website can show you why I was always frustrated with the so-called "free foods"--the simple fact that most of them are beverages and condiments. So I could enjoy large amounts of:

Diet Soda
Herbs & Spices
Soy Sauce
Whipped Topping
Teriyaki Sauce
Low-Sugar or Sugar-Free Jelly
Dill Pickles
Sugar-Free Gelatin

without guilt or too much worry over my blood glucose numbers. I have noticed that my previous free-food-favorites celery and cucumbers have been moved into the "non-starchy vegetables" category. Every once in a while, I get a craving for that old standby snack of my youth--celery sticks with Italian dressing. Mom always made the Good Seasons stuff from the packet, and I remember it was always tasty. Was I hungry in between snacks? Free food snacks would have to be found, unless my blood sugar was low.

Maybe I should blame the exchange system for me not making my own Jello more often.

I did a victory dance in the grocery store aisle a few months back when I discovered Splenda-sweetened Italian Ice Cups. I may have even asked them where they'd been all my life.

What is it that you remember about the good ol' ADA Exchange System?


  1. I remember the exchange system (I was dx'd in 1976) and I also remember that it made little sense, so as a kid, I also tended to "sneak" forbidden foods, too. The main benefit (if you can call it that) was that a) we did not have home blood glucose testing, and b) the hemoglobin A1C didn't emerge until the mid 1980's.

    Looking back on all of this, I have reached the conclusion that medicine didn't really know what they were talking about to a large extent, which help explains why the ADA is so opposed to low-carbohydrate diets even after softening their position on them late last year. I cannot help but wonder how much sponsorships from companies like Kraft play a role in this aversion?!

  2. Hannah,
    I was diagnosed in 1975-- so I had YEARS of the exchange system!

    I snorted out loud reading your mom's comments about your "awfully big 1/2 cup of ice cream!" I used to hear those same things.

    I remember one time we were out of milk, and I was supposed to have one cup at my "bedtime snack." My folks were gone (and there weren't cell phones!) so the parent I could get a hold of was my dad. (who wasn't really the expert in the food exchange system) I told him that we were out of milk and he said, "well, just have one cup of ice cream." I was thrilled beyond belief. Substituting ice cream for milk was the highlight of my short life.

    I used to read and read that free list--hoping that something yummy would jump out at me. Never did.
    BUT... I came to love pickles!

    Thank goodness for food labeling and carb counting!

  3. I wasn't on the exchange system, but it wasn't quite uninhibited freedom back when I was diagnosed. Set number of carbs per day,from which(barring lows) you did not deviate. I was always hungry, and though free foods took the edge off that hunger they didn't exactly satisfy it. Now, if one is hungry you can eat/bolus/or shoot but that wasn't in vogue back then.(Still moving away from the sugar is evil era, even though it was occasionally permitted) Free foods are good, but for me
    they conjure up memories of diet restrictions and what I couldn't have. (one should have the choice, between carbs and non carbs)

  4. diagnosed in '77 and I totally remember the free food list. When you're seven, who wants to read you can eat all the tea and teriaki sauce you want? Dill pickles, however, I scarf down to this day... now, though, I worry about the salt content.

    Hooray for carb counting.

  5. Hi Hannah, great post! The exchange system always felt restrictive to me too. Carb counting, and then pumping were such liberating things to me. OK, maybe some days a bit too liberating LOL :). Personally, I think "free" foods should have been called "what's the point?" foods.

  6. Ha! The lasting impact it has had on me (diagnosed in 1980) is the uncanny ability to add & multiply 15's...

  7. Oh the 15's! I ate the exchange based breakfast they served me in the hospital for months after I left. I think the exchange systems is what caused my tendencies to go on kicks of certain meals. I knew the exchange for specific meals so I stuck to them for long periods of time. I was also a fan of sneaking.
    Oh real carb counting how I love you!

  8. The ADA diet was placed on the kitchen wall right behind my seat at the table.

    A serving of grapes was only 12.
    I refused to eat grapes for a very long time.

    1 serving of strawberries ='d
    1 cup, which was more along the lines that worked for me!

    Great Post!

  9. I don't remember a whole lot about the exchange system (I was really young) but I know the fact that Jello was a free foods is why I hate it to this day!

  10. Anonymous1:21 AM

    I'm T2, diagnosed 2002, and was given an ADA fold-out 1800 cal/day diet sheet, a med-center 1000 mg sodium/day diet sheet, and told to figure out my way between the two of them. First thing I found is that the low-sodium diet sheet had one eating the whole day's sodium content in bread (150 mg Na/1-ounce slice). The Other Half had been given the ADA 1600 cal/day fold-out about 5 years earlier so I had some idea about exchanges. Problem was he exchanged out all his fruits and veggies for bread. I ended up picking up some useful books at Borders and decided that (1) the ADA diet was too starch-heavy, (2) it did not put enough emphasis on fresh fruits and veggies, and (3) it did not even think about the concept of healthy versus unhealthy starches and fats (whole-grain versus white flour, olive oil versus butter, etc.) I ended up modifying it to a "five by five" diet: five exchanges per day each of fruits, veggies, whole-grains, proteins-or-dairy, and fats (counting every fat gram from every grain or protein source towards thoses five fat servings). It worked fine until I developed iron-deficiency anemia and had to add in much more meat than should ever have to be in a safe-and-healthy diet...

  11. Oh my gawd, this brings back memories.

    A fruit roll up was 2 fruit exchanges.
    I got one fruit with lunch, so my mom would cut fruit roll ups in half. No one wanted to trade with me, ever.

    Free foods: pickles, mmm mmm mmm. And eating crystal light powder.

  12. I was dx'd in 1990 as well. I was in college and carried a small scale to the dorm cafeteria for every meal of the first semester post dx.
    One of my distinct memories was the required snack. didn't matter if I was hungry or not (or starving), I got something like 3 Triscuits or a couple cups of popcorn. Popcorn often won out.


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