Wednesday, June 3, 2009
I always have fun when Paul Eisenberg asks me to help with a story. Here is the original link to the story below.
If your strategy for not getting sick or hurt on your next trip involves staying away from any enclosed social environments, there’s definitely one you should add to your list.
It’s called civilization.
Of course, you can’t usually avoid that one. Even if you could, there are no guarantees that disease and injury won’t find you. According to the U.S. State Department, the leading cause of injury death among U.S. citizens traveling internationally is road traffic accidents. Homicide takes the number two spot, and drowning tops the list of leading injury causes among Americans visiting countries big on water sports.
Taking these and other statistics into account, one conclusion of the Center for Disease Control and Prevention (CDC) Yellow Book is that “injuries and violence are as much a public health problem to travelers overseas as are infectious and chronic diseases, and they are in many ways more deadly.”
This doesn’t mean that risks from disease aren’t real. They just may not be the biggest risks you face either where you’re going or how you’re getting there. “You aren't really any more likely to get a disease from being in an aircraft than you are from being on a train, bus, or shut up in a conference room all day with a group of people,” according to CDC travel health expert Dr. Phyllis Kozarsky, M.D.
Many of the reported injury-related deaths among American tourists would have been preventable if the travelers had used seat belts and child safety seats, avoided unsafe areas, or not consumed alcohol prior to swimming, according to the CDC. Likewise, despite any health risks posed by your destination or fellow travelers, the burden for having a healthy trip largely rests with you.
Prepare for the worst.
Of course, disease is a major issue in some parts of the world, and before heading off to an unfamiliar locale you should check out the CDC’s Traveler’ Health section, which includes a destination-specific section outlining health risks and precautions in top vacation spots, as does the State Department’s International Travel site.
If you’re traveling overseas with anyone who’s pregnant, elderly, under five, or has a pre-existing medical condition, consider seeing a travel medicine specialist as well as buying travel insurance that covers medical care, Kozarsky says. While you’re at it, “ask if your policy will pay to have you repatriated. You may prefer to be treated or recover from an illness here in the United States.”
Before you leave, make a list of medical contacts at your destination, suggests nutritionist Monika Woolsey, who also says to bring “a list of your meds and a short list of translated words that you can use to point to if you do have to see a doctor,” and ask your home physician if he or she will be available to take calls from foreign doctors while you’re away.
The CDC lists what should be in your vacation med kit, as does Woolsey, whose top supplies include medicine for treating and controlling diarrhea, an anti-inflammatory “good for fevers, sunburns, and aches and pains,” ointments for treating sunburn, scratches, and rashes, and an enzyme supplement that can help prevent gastrointestinal problems.
Does a mask belong on your packing list? “At this time, masks are not recommended,” Kozarsky says. “In situations where they are recommended, it is usually the sick person that wears the mask to keep from spreading germs,” she says, “and if you are sick, you shouldn't travel.”
Practice good hygiene
By now you know the rules to reduce the risk of spreading or catching germs: stay more than six feet away from sick people, avoid touching your face, and wash your hands. And carry hand sanitizer, especially in flight, observes Traveling Mamas blogger and former flight attendant Beth Blair, as “most airplane lavatories only provide cold water,” which is not efficient for killing germs.
Even if you wash or sanitize your hands after using an airplane lavatory, the simple truth is that “many of those who used it before you did not,” points out tour leader and Trip Chicks co-owner Ann Lombardi. “There are germs lurking on the door knobs and handles,” she notes, “and if you close the door from the outside with your freshly-washed hands, you can pick up some nasty germs again. Use hand sanitizer once you’ve returned to your seat” and clean your tray table with an anti-bacterial wipe, she adds.
Blair recalls that “as a flight attendant, I always made an effort to pass the beverage directly to each passenger. However, I've seen passengers coughing or sneezing all over their hands then ‘helping’ their fellow seatmate by passing their drink to them.”
Watch what you eat
Avoid eating raw vegetables overseas, especially in developing countries, Woolsey says, “due to the lack of knowing what was used to fertilize the vegetables.” Kozarsky also warns that “unpasteurized milk, certain cheeses, and food from street vendors can carry a risk of food borne illness.”
If you’re avoiding your destination’s iffy tap water, remember to avoid the ice as well as drinking from bottles that might have been chilling on it. Graze local snacks early in the day when displayed food is likely fresher, Woolsey advises, and pitch unrefrigerated leftovers or “you may be setting yourself up for food poisoning. Proteins can realistically only be at room temperature for about two hours before they start to spoil,” she says.
If all else fails
If you’re seriously ill or injured overseas, the local U.S. consular office will help you find appropriate care, Kozarsky says. Most resorts “have a physician they can call if your symptoms don't improve,” Woolsey notes. And Blair learned during a 14-hour wait in a New Orleans emergency room that it pays to “call various hospitals in the area for wait times if going to ER. Sometimes urgent care has shorter lines.”
If you become ill after you get home, ensure your doctor knows about any overseas trips you’ve made over the last six months. It’s routine for doctors to ask about this, Woolsey notes, “but I've seen it slip through the cracks. I did have a client once who had amoebic dysentery who had been diagnosed with an eating disorder. Her doctor was not used to asking about international travel.”
Also be sure you’re accurately reporting the details leading up to your sickness. “Gastrointestinal symptoms can take 48-72 hours to manifest,” Woolsey says, but “people tend to blame how they feel on the last thing they ate.” She recounts when her parents returned from Mexico with gastrointestinal problems.
“They blamed it on the last meal they'd eaten, which was at a high-end restaurant, but when we spoke a little longer it turned out they'd tried something from a street stand a day or two before.”
“I think we're more likely to be sick as a result of choices we make ourselves then we are from viruses,” says Woolsey. I certainly don't want to minimize the risk of viruses, but I think people need to be aware of what they inflict on themselves as well.”
Concurs Kozarsky, “you wouldn't get a tattoo at a sketchy parlor in the United States; don't do it on spring break overseas. Hepatitis isn't a good vacation souvenir.”
That said, Kozarsky adds, “we don't want people to worry. We want them to be prepared and to be able to enjoy their travels safely. And common sense is really the most important thing you can pack.”
Wednesday, April 1, 2009
My good friend Patrick Ward of Optimum Sports Performance wrote this for Air Vitals, at my request. The topic came up in a phone conversation and it seemed very pertinent to all of you!
I was recently asked a question about airline pilots and the effects that dehydration may have on their soft tissue, causing them to get tight and stiff following a flight. Really, this could apply to anyone who is flying across country (or across the globe) and it has special application to athletes who may have to fly frequently to get to competitions. Having the soft tissue in healthy working order is essential to performing at a high level.
Airplane cabins tend to very dry and, at least to me, often very hot. This dryness wreaks havoc on our bodies. Without water, we may sense ourselves feeling thirsty, our lips may start to chap and our skin gets dry. Our body gets dehydrated and the quality of the tissue begins to suffer. In addition to this, we are sitting in one position for an extended amount of time.
In these conditions, our tissue can dehydrate and harden due to stress, disuse and lack of movement, all which take place when we sit for hours on an airplane! Our tissues lose viscosity, harden, and become more gelatinous, creating friction when layers of fascia rub against each other. No wonder people feel so lousy after flying!
3 Tips for Frequent Flyers
1) Drink water!
Pass on the alcohol, the coffee and the soda and get yourself some water. In fact, make sure you adequately hydrated before getting on the plane. Bring your own bottle to the airport and drink it before during and after the flight.
2) Work on your soft tissue when you land.
Obviously, having a good massage/soft tissue therapist is a great way to maintain healthy tissue. However, when this is not an option, using a foam roller, the massage stick or even a tennis ball can be a great way to put some compression into the tissue and roll back and forth to help manipulate the soft tissue and prevent stiffness. Foam rollers can now be bought in smaller sizes, about a 1/3 the size of the long ones, making them easier to travel with.
3) Lengthen the tissue.
Once you have worked on the soft tissue, be sure and perform some stretches for the muscles you worked on to help restore proper length and extensibility.
Final note: I do run these posts past an experienced flyer before posting. My expert in this case shared that many pilots do avoid hydrating to avoid the complicated security procedure they must engage in, in order to leave the flight deck to use the bathroom. The one time he tried to at least hydrate shortly before landing...the flight was diverted and that became a problem, too...
...there's no perfect solution to this dilemma, except to be aware of the importance of hydration and do the best you can, when you can.
Friday, March 20, 2009
I wanted to share a question forwarded by Pat Lombardi at the University of Oregon, who wondered why I'd stated that we "need lots of protein".
Knowing that our demographic tends to be busy, often tired, and reading these posts on layovers and in busy airports, I like to keep them short. Which is challenging, given a complicated scientific issue such as protein needs. But I am going to try.
My statement was based on what I learned in doing market research with pilots and flight attendants before launching Air Vitals, and learning about what habits they had and what habits they were willing to change.
Quite simply, it gets really boring to eat tuna and turkey and it's a whole lot easier to carry on, and snack on, the high-carbohydrate foods available in newstands at the terminals. Or, to eat a fast food meal that comes with a huge order of french fries, or a large frozen yogurt. Those are not the foods that are going to help your energy, or weight. Many flight attendants and pilots carry their own foods on trips so they don't have to eat airport food. They're sick and tired of it.
I said what I did about protein to challenge readers to start doing two things. First of all, to become familiar with protein sources available in the airport, such as cheese in a fruit dish, or sushi like I saw recently in LAX. Secondly, to think of portable protein foods such as peanut butter packets, string cheese, or jerky as recommended by Ivonne Berkowitz-Ward in the foxnews.com article (I'm partial to salmon jerky myself).
I was not intending to encourage anyone to overload on protein. I assume that most readers are intelligent and will make choices that do not overload them. I was trying to highlight an issue our market research said was important to address with this demographic without it becoming lengthy and impractical for the reader.
I really appreciate Pat's comments and hope everyone understands where I was going. I can do the heavily referenced scientific writing thing but it's not pretty to read and not what I believed this audience was looking for.
Comments are welcome and I'm really grateful Pat provided an opportunity to clarify! It's awesome when colleagues keep us on our toes! :)
Tuesday, March 17, 2009
I was super excited that this article finally went live...then the first few sentences into it, I realized my great friend and colleague Ivonne Berkowitz-Ward had ALSO been interviewed!
Paul clearly has good taste in interview subjects!
Seriously, it's an honor to be on the Internet with such a great professional and I'm happy the article is so full of great ideas for eating well while traveling.
Saturday, March 7, 2009
It's Time to Decelerate!
I, too, want to express my gratitude to the pilots and flight crews who deliver us safely to our destinations. We place our lives in your hands on a regular basis and that is a big responsibility! And with responsibility often comes STRESS!!!
When the body encounters acute stress, such as that Captain Sullenberger experienced, stress hormones are released which stimulate carbohydrate and fat metabolism to provide the quick energy needed for a "fight or flight" response. This raises blood pressure, quickens respiration and tenses muscles, allowing us to react quickly and efficiently in the situation.
But, what happens when we are under constant stress? Well, our bodies respond with the release of hormones, including cortisol. Chronically elevated cortisol levels can stimulate appetite, especially for high calorie foods. This results in increased fat storage, especially in the abdominal region (called visceral fat). It can also decrease metabolism, meaning your body does not burn as many calories - more fat storage results. Insulin resistance, cardiovascular disease, poor sleep quality and impaired immunity are also more likely to occur.
Each of these causes its own set of problems with their own possible dietary interventions, which we can go into at another time. For now, don't spend those sleepless nights ordering cortisol-blocking supplements from some infomercial on TV - they don't work! The key is to incorporate stress management techniques into your lifestyle.
When possible, spend 20-30 minutes each day in some kind of relaxing activity (a hot bath, meditation, yoga, music, reading, etc). If you can't get in 20 minutes, at least take a few moments to close your eyes and do some deep breathing (of course, you will want to be parked safely at the gate before you do this!). Exercise helps rid the body of cortisol, enhances sleep, and releases endorphins. Try to incorporate movement daily and weight lifting twice/week to minimize abdominal fat gain.
While travelling (especially when that is your JOB!) can make self-care, like mindfulness, sleep and relaxation challenging - it is imperative to your good health. But, don't stress over the stress-reduction!! Take a deep breath and give thanks that you're not landing in the Hudson River right now!
Wednesday, February 18, 2009
If you're here because you read Paul Eisenberg's article on healthy eating while traveling...so glad you stopped by!
If you're a frequent traveler...pilot, flight attendant, or someone back in the fuselage...we want to know what you wish to know about.
We've got more information and events coming, please send a request to be on our mailing list to firstname.lastname@example.org.
In the meantime, safe travels and tasty eating!
Friday, January 23, 2009
Little did Captain Sullenberger anticipate last Thursday, as he ordered breakfast at his New York hotel, that within hours he would be called on to have split second reaction time, absolute mental clarity, complete decisiveness in his thinking, recall of every training session he'd ever completed, and utter confidence that he could manage the most challenging situation his life had ever laid before him.
By now we all know the story well. This man is now the pilot many Americans want to fly whatever plane they may be boarding for whatever business or vacation plans they may have.
If you're NOT a pilot and you stumbled on this blog, take heart, what Sully and his crew did, is what any crew in the same situation would be doing to maximize your personal safety. I don't say that to minimize the bravery displayed last week, but rather to recognize that it takes a certain bravery of character to even BE a pilot. We as passengers are just incredibly fortunate that it is not often we have to be reminded of that.
I'm grateful for the bravery and training of every single pilot who has ever safely delivered me to my destination.
Nothing is more important than experience and training in flight emergencies. However, I couldn't help but think about how many qualities of omega-3's pertain to a pilot's job duties. Research has shown that these essential fats, to name just a few:
--help the brain filter out unnecessary information and focus on important information
--help the brain retrieve information from its memory
--help with reaction time
--help improve sleep architecture so that daily functioning is more productive
--help the brain respond to anxiety producing situations in a way that promotes focus on problem solving rather than being paralyzed out of action
--controls rises in blood pressure to keep things going
They're truly key in making sure an emergency gets the correct sequence of responses.
If you're not eating a lot of fish, consider starting. If you don't like fish, consider fish oil capsules.
There will be a lot more on this topic to come. For now, just consider that even if you're not called upon to land a huge aircraft in a ridiculously challenging situation...the right kind of fats can put you in the best possible position to orchestrate all those every day challenges (near misses, wind shear, etc.), that most passengers never even realize you've protected them from.
Thursday, January 1, 2009
I hope whether this post finds you on a stopover, a layover, or happily at home with loved ones, that 2009 is a year you are looking forward to.
Diane and I are very excited to bring this idea to life, and we'd love to hear more from you if you have ideas about information you'd like to see more of, less of, what kinds of services we can offer to augment this blog, you name it. Air Vitals is YOUR venue, and we're simply here to make sure it happens.
We'll be meeting later this month to formalize some of our plans, and our planning will be so much more meaningful if it contains thoughts and ideas from those who travel for a living.
Please, anytime you have an idea, contact us! You can either comment here on the blog, or you can email me at email@example.com, or Diane at firstname.lastname@example.org.
Safe travels, and we'll see you soon!
Monika M. Woolsey, MS, RD
Co-founder, Air Vitals