Jun 5, 2013

Belly Health on the Road

Johanna Read / Food Travel, Survival, Travel Abroad / digestion, health, wellness / 2 Comments

Eating is one of the joys of traveling. You get to try new foods and drinks in beautiful new settings.

But eating – and drinking – are also essential to give you the energy and hydration you need to complete those hikes in the jungle, relax on the hot beach, and take yet another photo of yet another ruin.

And eating and drinking properly are essential to keeping healthy on the road.

Usually the aim of my columns is to make your mouth water and your hands either book a flight or whip up the recipe I include. This column will have the opposite effect. But you’ll thank me later.

Many travelers succumb to Delhi Belly, Montezuma’s Revenge, the runs, or whatever the polite term is for travelers’ diarrhea in their current locale. People often blame the water or the food. And yes, sometimes these are the guilty parties.

You do want to make sure you use bottled or purified water (and ice made from it) if the tap water isn’t safe, that you peel fruits, that foods are stored and served at their proper temperatures, and that restaurants use safe food handling practices. (I remember a resort in Cuba where I watched a cook grill chicken breasts to perfection on the barbeque, but then put them back on the same plate that held the raw meat. Ewwwwww. And people blamed the tap water for their belly trouble!)

But not all travelers’ diarrhea is caused by the quality and cleanliness of the food that the traveler consumes. Often it is simply the types of food we choose.

When we’re on vacation we eat differently than at home. We drink more booze, cool off and hydrate with sugary drinks more often than water, and snack on more junk food. When we’re in a hot destination, even more so. And sometimes it is hard to find healthy food, even if we’re looking for it.

I’m in Panama at the moment. It is hot and sunny and it rains for an hour every day or so. Perfect conditions for lots of fresh produce at every restaurant and corner store, right?

Wrong. This is banana and pineapple country, and these are often easy to find. On the mainland. I’ve spent three weeks on two different islands, and some days you can buy them, and other days the shelves are bare. Mango and watermelon appear sometimes. And limes. But that’s about it.

In the veggie department I’ve seen some wilted and brown iceberg lettuce, some mealy-looking tomatoes, and some root vegetables I’m not familiar with. Occasionally some carrots. Not much else.

And this is what is available to everyone – not just tourists, but local shoppers and restaurants too.

I try to eat healthy, plus buy a whole pineapple every day I find one, but keeping a healthy belly while traveling takes effort.

So traveler, remember these belly health rules:

Medical
- If you have diarrhea, drink a lot of water. It is very easy to get dehydrated. It is unlikely, but you may also need to replace electrolytes (try Gatorade or, even better, a product like EmergenC).

- If you “just” have diarrhea, without vomiting or a fever, consider that you might NOT have a bacteria-, parasite- or virus-caused illness. What have you been eating the past few days? Perhaps you just need some fiber.

- However, if you have blood in your stool seek medical attention immediately. And if your symptoms persist or worsen, see a doctor. Better safe than sorry.

- Don’t take Imodium (loperamide), unless you have a long bus ride to get through. If you’ve got bad stuff in your gut, you want it out, not blocked up in there.

- Ask your travel medicine doctor to prescribe a traveler’s diarrhea antibiotic to bring with you. Eat some fiber before you resort to it though – we have enough antibiotic resistant bugs out there already. And if you do take an antibiotic, try to re-introduce the good bacteria back into your gut with yogurt or acidophilus supplements.

- Depending on your destination and the sensitivity of your belly, ask your travel doc about Dukoral (http://www.dukoralcanada.com/), a cholera and E.coli vaccine. Yes, its fake raspberry flavor is disgusting (and even worse on the second dose), but it works.

Eating and Drinking
- “Boil it, cook it, peel it or leave it!”

- Drink a lot of (bottled or purified, as needed) water … enough to make sure you pee clear. Make sure your bottled water is sealed (not just refilled from the tap).

- Try to eat as much variety as possible.

- Go out of your way to eat lots of fruit and veggies. However, depending on the cleanliness of the water at your destination, this can be hard when trying to follow the “boil it, cook it, peel it or leave it” rule. And, unless in Asia, it is unlikely you’ll get enough without regularly ordering salads or vegetarian dishes in restaurants. So, buy fruit on the street and in the grocery store. Buy packaged dried fruits (yes, especially prunes) for road snacks.

- Drink fruit shakes/smoothies. Lots of destinations have gotten into the smoothie craze, and they’re often easy to find and only slightly more expensive than a can of Coke. Make sure they blend actual fruit (not just juice) and that water (and ice) is bottled if tap water is unsafe.

- Street food, if it is cooked hot in front of you, is most often very safe. Look for lineups of locals – high turnover and local trust are a good thing. But keep an eye out for how utensils and plates are cleaned/stored. You might want to carry your own spork or chopsticks (also a smart environmental choice).

- Avoid buffets, even in the finest of restaurants, and any food that has been sitting at room temperature.

- Avoid pastry filled with meat. These convenient meal packages often sit for days, and aren’t reheated to sufficient temperature to kill whatever is growing inside them.

- Use powdered fiber. Metamucil is for your grandparents. But Benefiber (http://www.benefiber.com/index.shtml) is tasteless and textureless and ensures your digestion is, well, as the ads say, regular. Stir a spoonful into your coffee, smoothie, or shake some into your bottle of water. Your mouth will not notice it is there. But your gut will thank you.

Wash Your Hands
The easiest solution to staying healthy and avoiding colds, flus, and worse: wash your hands frequently and avoid touching your mouth and nose.

I’m not saying you need to keep dousing yourself in Purell. Frequent soap and plain old tap water are fine.

Giardia, a very nasty parasite, is not just in drinking water, but on door handles and handrails too. Norovirus, what most people actually have when they have the “stomach flu,” loves anything you touch with your hands. On a cruise ship? Press the elevator buttons with your elbow! And get out of the habit of touching your face.

Lastly, don’t be fooled into comfort by restaurants which require employees to wear gloves. People tend to keep their hands cleaner than their gloves, so a cook or sandwich assembler with gloved hands is often dirtier than an ungloved one.

So my fellow travelers …. travel widely, eat well, and stay safe.

And no, I’m not giving a recipe this month. Do you actually have an appetite after all this diarrhea discussion?