How to Stay Healthy During the Winter Travel Season

by Edward R. Rosick, DO, MPH, DABIHM

via Wikipedia

December in the Midwest brings many things–the start of winter, the end of a school semester, the holidays of Christmas and Hanukkah, and of course, the great migration of to parts south. While I love my home in Michigan, I am more then happy to leave our seemingly endless winter days of clouds and cold and join my fellow travelers in seeking out a climate where ice is only found in cold drinks and not in lakes or coating our roads. While the thoughts of going on a winter vacation are certainly happy ones, too many forget that traveling to parts south in search of warm weather and sunshine–especially if it’s to areas outside the United States–can also bring the risk of getting sick and turning that week of fun and sun into a time of misery.

More Than Just Strange Places

It’s not that traveling in and of itself causes you to become ill; it’s everything associated with it that puts you and your immune system –a vast network of cells that patrol our body the way soldiers protect their countries–at risk. The problem can actually start at home, when we’re hustling and bustling to get ready for the trip and neglect to get sleep. There’s multiple studies that show that sleep deprivation leads to immune system impairment (3,4). Add that to dealing with jet-lag when flying to areas of the world in different time zones, and right off the bat you can be at higher risk for getting sick.

Precautions When Flying

While we’re on the subject of flying, a study reported last summer at the annual American Society for Microbiology meeting showed that getting from point A to point B in the air can be fraught with potential illnesses.(A) The study showed that diseases–including the pathogens methicillin-resistant Staphylococcus aureus (which can cause skin infections and pneumonia) and E. coli O157.H7 (which can cause respiratory illnesses and diarrhea) can survive up to one week on airline cabins arm rests, window shades, and tray tables. Because of studies like this one, I recommend to my patients that are traveling to their favorite vacation destination to take certain precautions when flying, including wiping down their seats and tray tables with disinfectants before using them, staying well-hydrated during flight (and not with beer and whiskey!), and to use a nasal saline spray to keep your mucous membranes moist, which can reduce the risk of airborne diseases.

 The Right Foods and Probiotics

“That’s it?” some of you might be saying. “There’s nothing else we can do to stay healthy when traveling besides wiping down our seats and spraying salt water up our nose?” Fortunately, there are other healthy tricks you can do to keep your immune system strong and fight off any bacteria and viruses that are lurking to ruin your vacation. For one thing, you should be eating a healthy, well-balanced diet full of fruits and vegetables; studies have shown that deficiencies in micronutrients (such as vitamin A, C, D, zinc, and copper) caused by eating less-than-nutritious diets contributes to an impaired immune system, which can lead to you getting sick. (5,6). What you put in your mouth–and therefore in your gut–truly matters to your immune system, because, believe it or not, most of our immune system resides in our digestive tract.

Fortunately, we can use this fact to help strengthen our gut–and our immune system–by eating foods that are high in probiotics, or literally, “good bacteria.” There is now a plethora of data showing that probiotics can help strengthen our immune system and help us fight off a myriad of diseases(7,8). Just a small sampling of the most recent scientific literature yields a number of articles showing the importance of probiotics for everyone–men, women, young, and old (9,10,11). Even taking supplements that contain some of the crucial components found in probiotics can be of benefit. An article in the journal Probiotics and Health highlighted a study of a probiotic formulation on the immune system in mice (12). Researchers conclusively showed that mice given a supplement containing active parts of the probiotic, Lactobacillus rhamnosus V, had a statistically significant increase in blood levels of chemicals known as cytokines, which are known to be part of the immune system when compared to mice that were not given the probiotic formulation.

Even More Benefits of Probiotics

In addition to strengthening your immune system, taking probiotics during your travels can significantly lessen your chances of coming down with the most common, and often, the most debilitating diseases causing illness in sun-seekers–travelers’ diarrhea. A review article in the Journal of Travel Medicine stated that traveler’s diarrhea is the number one health problem noted among international travelers, with the incidence ranging from 13 to 54%.(B). While travelers’ diarrhea is generally a mild illness, telling that to a person who has spent thousands of dollars on their trip, only to spend it sitting on a foreign toilet, isn’t likely to gain you many friends! In addition, to those with other medical problems or a compromised immune system, traveler’s diarrhea can a much more serious, life-threatening illness. Yet with the judicious use of probiotics, travelers’ diarrhea can actually be prevented.

An article in the Journal of Travel Medicine and Infectious Diseases examined the efficacy of probiotics in preventing travelers’ diarrhea in a meta-analysis of 12, randomized, controlled clinical trials. The authors of the study found that, in their own words, “…probiotics are safe and effective for the prevention of TD [travelers’ diarrhea]. The pooled risk estimate found that 85% of TD cases were prevented by probiotics.” In addition to this great news, probiotics can also prevent antibiotic-associated diarrhea. Antibiotics are often prescribed to treat cases of travelers’ diarrhea, yet sometimes these very same medicines cause the symptoms(i.e, diarrhea) they were supposed to treat. A study in the journal Pharmacotherapy showed that taking the probiotic Lactobacillus, along with antibiotics, significantly decreased the risk of developing antibiotic-associated diarrhea.

Travel safe, sane, and healthy!

It’s a wonderful thing to get on an airplane in cloudy, cold weather and get off in a place bathed in warm winds and sunshine. I’m greatly looking forward to taking my children to the sunny south this winter to where, for at least a week, we can forget the snow and cold that will hold Michigan in it’s wintery grasp until spring finally comes around. For those of you that will join all the rest of us on our yearly pilgrimage to parts south this winter, eating healthy, getting enough sleep, taking the appropriate supplements and finally, remembering the benefits of probiotics can make your trip fun and enjoyable rather then one filled with misery and frequent trips to the bathroom!

  1. Hurtado-Alvarado G, Pavon L, Castillo-Garcia SA et al. Sleep loss as a factor to induce celluar and molecular inflammatory variations. Clin Dev Immuno 2013; Epub.
  2. Tauseef A, Choe J, Ahmed A et al. Sleep, immunity, and inflammation in gastrointestinal disorders. World Jour Gastro 2013; 19(48): 9231-39.
  3. American Society for Microbiology. Harmful bacteria can linger on airplane seat back-pockets, armrests for days. Science Daily 20, May, 2014.
  1. Calder PC. Feeding the immune system. Pro Nutr Soc 2013; 72(3): 299-309.
  2. Calder PC, Kew S. The immune system: a target for functional foods? Br Jour Nutr 2002; 88: S165-77.
  3. Moai VL, Servin AL. Anti-infective Activities of Lactobacillus Strains in the Human Intestinal Microbiota: from Probiotics to Gastrointestinal Anti-infective Biotherapeutic Agents. Clin Micro Reviews 2014; 27(2): 167-199.
  4. Alexandre Y, Blay GL, Boisrame-Gastrin S et al. Probiotics: A New Way to Fight Bacterial Pulmonary Infections? Med et Maladies Infect 2014; 44: 9-17.
  5. Gibson MK, Pesesky MW, Dantas G. The yin and yang of bacterial resistance in the human gut microflora. Jour Mol Biol 2014 Epub.
  6. Vieira AT, Teixeira MM, Martins FS. The role of probiotics and prebiotics in inducing gut immunity. Fron Immuno 2013; 4(445): 1-12.
  7. Duncan SH, Flint HJ. Probiotics and prebiotics and health in ageing populations. Maturitas 2013; 75: 44-50.
  8. Sichel L, Timoshok NA, Pidgorskyy VS, Spivak NY. Study of interferonogenous activity of the new probiotic formulation Del-Immune V. Probiotics and Health 2013; 1(2): 1-6.
  9. Rack J, Wichmann O, Kamara B et al. Risk and spectrum of diseases in travelers to popular tourist destinations. Jour Trav Med 2005; 12: 248-253.
  10. McFarland LV. Meta-analysis of probiotics for the prevention of travelers’ diarrhea. Travel Med Infect Dis 2007; 5: 97-105.
  11. Kale-Pradhan PB, Jassal HK, Wilhelm SM. Role of Lactobacillus in the prevention of antibiotic-associated diarrhea: a meta-analysis. Pharmacotherapy 2010; 30(2): 119-26.

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