Holiday Health: How to Stay Well Before, During and After Travel

Travelling should be enjoyable, but digestive upsets, sunburn and lowered immunity can get in the way. Discover evidence-based tips and key supplements to help you stay well before, during and after your holiday.

Holiday Health: How to Stay Well Before, During and After Travel

Digestive upsets when travelling: Causes and prevention

Whilst spring and summer are considered to be peak holiday seasons, more and more people are choosing to travel all year round, whether getting some winter sun or enjoying a city break. One of most common issues when traveling is stomach or digestive upsets, which is often called travellers' diarrhoea by healthcare professionals. It is estimated that between 30-70% of those travelling abroad will experience this issue,1 and this affects 12 million people per year. This condition is normally caused by bacteria, viruses or parasites and can be more common in situations where there is close proximity such as cruises or in large tour groups.2 The main symptom is diarrhoea, with stomach cramping and nausea in some cases. These are normally mild but can become serious in small children and the elderly or those who have a compromised immune system as dehydration often accompanies diarrhoea.3

Even in mild cases, these symptoms can be disruptive for several days and may restrict activities and even cause delays or changes to travel plans. As it is often caused by variations in food hygiene, high risk foods such as meats, seafood and dairy products and water supply, using bottled water, avoiding ice and washing raw foods with bottled water is sensible. However, some studies have suggested that these measures only offer a small benefit.

Taking a good probiotic prior to travelling has been widely investigated for this issue4 and a meta-analysis of 12 studies showed that a variety of probiotics, including Lactobacillus acidophilus, Lactobacillus rhamnosus and Saccharomyces boulardii prevented 85% of cases of traveller's diarrhoea.5,6 Saccharomyces boulardii is a particularly useful product to consider as it is often room temperature stable, making it ideal for travelling as it does not require refrigeration. It has also been shown to reduce the incidence of traveller's diarrhoea by over 20% if used just prior to, and during travel.7

Sunburn: Understanding SPF and sun protection

Unsurprisingly, sunburn is one of the top holiday complaints, whether travelling in the UK or abroad. 46% of those travelling outside the UK get sunburnt according to a survey conducted by the British Association of Dermatologists. But even in the UK over 30% of people got sunburnt, and we are less likely to use any kind of suncream when holidaying in the UK. Incorrect use of sun cream is also a huge factor – applying less than is recommended and less frequently, using expired products or the incorrect sun protection factor (SPF) often means that we are poorly protected from this painful condition.8

Understanding SPF is vital as many people do not understand which option to choose. SPF will indicate how well a suncream will protect you from a sunburn: for example if you would normally burn in 2 minutes unprotected, an SPF of 30 will increase this time to 60 minutes and an SPF of 50 will increase it to 100 minutes. However, this only works if the cream is applied in sufficient amounts with the current recommendation is two tablespoons for the whole body and face. Multiple studies as well as anecdotal evidence shows that this recommendation is rarely followed, with most people only using a quarter to half of this amount. This can reduce a cream with an SPF of 15 to as little as SPF 3-5.9 Poor application and failing to reapply regularly or after swimming and drying can also make painful sunburn more likely.10

Treating sunburn and nutritional sun protection

Sunburn can be very painful and whilst it is rarely serious, it can really ruin the enjoyment of a holiday. Covering up, cooling the affected area and keeping well hydrated will all help with symptoms. More worryingly, getting sunburnt once every two years is enough to increase risk of melanoma, according to research by Cancer UK. Checking for expired suncream and familiarising yourself with the correct SPF and application can all help to avoid this condition.

In terms of products to use to help this condition, a good cooling aftersun with aloe vera is often recommended. Supplements can also be of some benefit but need to be taken prior to travelling. Several different plant compounds, including carotenoids and flavonoids such as those found in green tea, seem to be useful for reducing sun damage, both long-term issues and shorter-term sunburn.11 The use of carotenoids such as beta-carotene and lutein have been shown to reduce the redness associated with sunburn.12 Other studies have shown that polyphenols from green tea and grapeseed have similar protective effects, reducing inflammation, acting as antioxidants and reducing the overall damage that excessive sun exposure can cause.13 A study exposing patients to the amount of radiation needed to cause skin reddening or sunburn found that the use of green tea reduced reddening suggesting an internal SPF from green tea.14 A combination of grapeseed, bilberry, lutein and green tea taken orally has shown the equivalent of an SPF of 10 after 12 weeks and SPF 15 after 24 weeks of use.

Eating well on holiday

Many people also find that they overdo food and drink whilst on holiday, this can often lead to issues such as indigestion, nausea and weight gain. Most nutritionists try to encourage the 80:20 rule – with 80% of what you eat being nutrient dense foods such as lean meats, fish and proteins, fruits, vegetables and wholegrains, with 20% less healthy options. Take advantage of the local foods and cuisines - if you are in the Mediterranean why not try the famous Mediterranean Diet, which is associated with heart and cognitive health. This diet focuses on polyphenol, potassium and magnesium rich fruits and vegetables, foods such as nuts and seeds which contain both omega 3 and 6 fatty acids, olive oil and lean meats and oily fish, such as herring, mackerel, salmon and sardines which are also rich in omega 3 fats. They recommend that processed foods are avoided, and the emphasis is on the consumption of fresh, unprocessed or minimally processed foods which are naturally much lower in sugar, salt and trans and hydrogenated fats.

Eating pro and prebiotic foods such as onions, chicory, garlic and yogurts may be useful for encouraging good bacteria. Having 30 different plant-based foods a week can also help to create a diverse gut microbiome, which may reduce the risk of any bad bacteria colonising the gut.

The let-down effect: Why we get ill on holiday

Another common holiday illness, called the let-down effect, is not always associated with going away but explains why so many of us come down with a minor infection such as a cold, when we finally get the chance to relax. The stresses of work or even holiday planning, can cause us to become accustomed to functioning with high levels of the hormones associated with the fight or flight response. When we relax and levels drop, this can cause a drop in immunity and also an increase in conditions such as migraines,15 asthma, digestive and skin conditions. Destressing slowly seems to be a good option and taking an adaptogenic herb such as ashwagandha or rhodiola may be helpful as both have been shown to reduce and regulate cortisol production16 and support immunity.17,18

Supporting your immune system before and during travel

As there is a link between periods of relaxation and lowered immunity, and as so many overseas holidays will require air travel, where the potential for transmission of infections is high, preparing the immune system prior to travel should be considered. There are many nutrients which are necessary for immune function to be optimal and low intakes of any one may be detrimental to the ability to fight off pathogens. Vitamin C is well known for its effects on immunity, and has been shown to enhance immune cells and also increase their production and function.19,20

Studies show that a sufficient level of Vitamin D is essential for the production of immune cells.21 Low serum Vitamin D is associated with an increased rate of infection and more sick leave. A study in 2010 showed that supplementation with Vitamin D reduced the incidence of flu by 42%.22

Zinc is another nutrient considered to be relevant for the immune system to function normally.23 Zinc deficiency impairs the immune response and is required for the proper function of immune cells.24 Given that National Diet and Surveys suggest that over 40% of men and women do not consume enough zinc in their diets, and as studies suggest that this has a role in reducing the incidence of colds, pneumonia and respiratory infections, this is a vital mineral for immune function.

There are also several herbs and other nutrients which can support immune function in various ways. Beta Glucans are a group of naturally occurring compounds, most often found in fungi and medicinal mushrooms, but often commercially derived from yeasts such as Saccharomyces cerevisiae. They have been widely studied and the effects on the immune system are multiple. Firstly, they make the immune response stronger. They also train the immune system to be ready to react to infections more effectively.25,26 Studies also suggest that beta glucans influence allergies, improving symptoms such as sneezing, eye watering and quality of life in those with seasonal allergic rhinitis and hayfever.27

Elderberry is traditionally used for supporting the immune system, which seems to be mainly linked to its content of anthocyanidins, a group of plant polyphenols found in dark purple and red fruits. These appear to be able to attach to viruses which then prevents them from entering cells28 and it has been shown to inhibit cold and flu viruses.29

References

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