Hi Sonja,
In the 1950's the exchange program was developed for diabetics. The exchanges themselves haven't changed much if at all since then. However, many diet programs have used the exchang concept (which is great, because most of their exchanges and therefore cookbooks are interchangeable). Weight Watchers was an exchange plan before 1997, Richard Simmons' plans (like Deal-a-Meal and FoodMover), Healthy Exchanges, Duke University (their new book "The Duke Diet" and TOPS (Taking off pounds sensibly, a non-profit weight loss club that meets weekly like Weight Watchers), and the website Hillbillyhousewife, and many others.
How these plans differ isn't in the exchanges themselves, but in how many of each exchange servings you are allowed. The Duke Diet book, gives you the choice of high and moderate carbohydrate plans, and the Hillbillyhousewife website gives three different carbohydrate plans for several different calorie levels.
Once you understand the exchanges, you can pick any of the plans, or design your own to follow. The biggest difference between the plans seem to lie in the distribution of carbohydrate, dairy, and protein exchanges. So what I did is select minimums for each exchange based on all of the other exchange plans, and then selected a number of flexible exchanges that I could use interchangeably (so I could say choose a starch, fruit, dairy, or protein exchange depending on what I wanted).
Generally, I try to select whole grains, lean proteins, and avoid sugar and white flour.
My plan is wonderful, and when I stick with it, I lose weight steadily. My biggest problem, especially this time of year, is the tendency to go off plan one or two days a week (which can undo all of the progress made the other 5days).
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