The gut, probiotics and travel

Supporting your microbiome whilst traveling – for holidays, work or any trips away from home

Our gastrointestinal (GI) tract contains a complex, but relatively stable population of bacteria, known as the microbiome, that play an important role in nutrition, metabolism, regulation of immune function, and protection.

This stability and balance can be affected by a number of factors, including diet, food poisoning, gut infections, antibiotics, stress, and aging, and traveling abroad can expose us to some of these factors and potentially result in undesirable consequences that may continue for some time after we return home.

Environmental changes relating to travel include stress, lack of sleep, dehydration, altitude changes, and disrupted body rhythms and they can all affect gut balance. They can also be further exacerbated by eating local food, increased alcohol intake and exposure to local water, and unfamiliar local bacteria and toxins.

Common holiday-related illnesses

There are a number of ailments that are directly linked to holidays and particularly whilst traveling overseas, the main ones being:

• Travellers’ diarrhoea (TD) is the most common holiday illness and primarily results from the consumption of local water and foods, which expose us to new types of bacteria that our bodies are not accustomed to.
• Bloating, flatulence, and constipation (or slower stool transit times) can be a side effect of long periods spent sitting during travel and can also result from changes in air pressure when flying, particularly on long-haul flights.
• Prickly heat (heat rash) happens when sweat is trapped under the skin and can come on suddenly in hot and humid climates. It is more common in children and can be very itchy and uncomfortable.
• Sunburn and heatstroke – we are rarely exposed to strong sunshine in the UK and may be tempted to spend hours outside in the heat when we first arrive on our holiday. This can result in sunburn and heatstroke and supporting our skin with antioxidants (vitamins C and E, zinc, and selenium) can help to provide some protection.
• Hay fever is a reaction to pollen and can occur in warmer climates where there are more trees and other blooming plants. It can be more noticeable when we are on holiday as we spend more time outdoors
• Jet lag – traveling between different time zones (particularly where there is a large time difference) can disrupt our natural circadian rhythm and this can lead to jet lag, which affects sleep, energy, and mood and can also impact digestion and make us feel generally unwell.

Why do people get ill on holiday?

People often complain that they fall ill when they take time out from their normal routine to go on holiday and embracing a healthy lifestyle is key to helping to avoid ailments both at home and on holiday. Maintaining our daily routine as much as possible can help to ensure we do not fall ill – eating similar foods, getting lots of rest, and maintaining an exercise regime.

It appears that people have been particularly susceptible to illnesses when traveling over the past couple of years, as many have been confined to their homes for long periods of time and have been wearing masks when leaving home. As a result, they have been exposed to a smaller range of environmental toxins, have reduced exercise levels and less exposure to sunshine, and may be more prone to illness when exposed to new environments.

Supporting our health before a holiday

Many people tend to be healthier in the summer months as the warm weather encourages us to spend more time outside and we are more likely to expose our skin to the sun and to engage in outdoor activities. We may also be inclined to eat less and indulge in lighter foods and drink more water.

These are key benefits of holidays and trips to sunnier climates and all of these elements can help to support our health and can be implemented prior to boarding the plane, train, or automobile. In addition, the following recommendations can also help both prior to and during a trip:

• Stay hydrated and drink around 3 litres of water every day and more in high temperatures or if exercising.
• Spend time uncovered in the sunshine – be careful not to burn, but allow skin to change colour slowly as this indicates that it is producing vitamin D.
• Take cold showers every morning – these are easier to tolerate in the warmer months and help to stimulate the vagus nerve and increase parasympathetic nervous system activity (known as the ‘rest and digest’ system). Adding a two-minute cold shower to the end of your usual morning shower is a great way of including this in your daily routine – start with 30 seconds and move up by 30 seconds each week until you reach two minutes.
• Support your digestion to ensure regular bowel movements – we should all be emptying our bowels at least once every day. Digestive enzymes, betaine HCL (hydrochloride), prebiotics and probiotics can all help – in supplement and food forms, if available.

Diet and lifestyle tips

In addition to the general tips above, we have compiled a long list of specific diet and lifestyle tips that can help to prevent holiday illnesses:

• ●        Don’t worry about becoming ill – focusing on something and worrying about it may result in noticing any small changes, leading to further worry and feelings of stress and eventually to feeling unwell.
• Don’t stray too far from your usual diet – we all like to try different foods and drinks whilst on holiday and trying one new food a day and avoiding any foods that you know trigger a reaction, such as gluten, dairy or sugar, can help to ensure we remain healthy.
• Avoid local water – drink only bottled or boiled water and be aware of food washed in local water, such as salad and fruit, and ice in drinks. Local water can include bacteria and parasites that our body is not used to and ingesting them can lead to traveller’s diarrhoea and other digestive issues.
• Stay hydrated – it is easy to become dehydrated whilst travelling and to underestimate the amount we need to drink to remain hydrated in warmer climates. Bring your own bottle and keep refilling it with bottled or boiled water, both during transit and throughout your holiday. Drink a minimum of three litres of pure water every day – do not include tea, coffee or sugary drinks in the total.
• Limit alcohol and caffeine intake – this can help us to avoid dehydration and constipation. Caffeine and alcohol can also speed up digestion in some cases and lead to diarrhoea, which can be an issue when travelling.
• Focus on eating healthily – eat lots of fibre to help keep your bowels moving. Include vegetables, fruits, nuts, seeds, beans and healthy fats and protein. And don’t over-eat.
• Get enough rest day and night – a different bed, in a new environment, with different noises, temperatures and smells can all affect sleep. Combining this with time-zone variations and the resulting jetlag and change in routine, can lead us feeling unwell. Try to adjust to the local time-zone as quickly as possible and build in some periods of rest during the day.
• Move your body every day – exercise, stretching and any form of movement can help to support your digestion – and can also help with preventing swollen feet and legs and other discomfort. It is useful to get up and walk around on the plane, or at least do leg, ankle, arm and neck exercises in your seat. Stretching or doing a bodyweight workout in our hotel room can help as will staying active throughout the holiday.
• Pack herbal teabags – packing some herbal teabags in your hand luggage can help to provide additional support. Include peppermint and ginger to support gut health, elderberry and Echinacea for immunity and camomile or lemon balm to support sleep.
• Stock up on healthy snacks – pack your own healthy snacks for the flight (nuts, protein bars, fruit) and find a grocery store on the first day of your holiday to stock up on nutritious snacks to prevent the temptation to grab whatever is available throughout your trip.
• Don’t eat anything you’re not sure about – if you have any doubts about food or drink you are offered, don’t eat or drink it. And be careful of salads washed in local water (especially lettuce) – cooked vegetables are a safer option.
• Don’t suppress the urge to empty your bowels – some people (particularly children) don’t like pooping outside their own home and suppress the urge when it happens. This can be a particular problem on holiday and can lead to constipation and digestive issues. Eating correctly, remaining fully hydrated and moving regularly can help to keep everything moving.
• Support healthy bowel habits – as well as probiotics, there are a number of other supplements that can help to support healthy bowel habits and to support overall health. Magnesium helps to calm the nervous system and is also a muscle relaxant so can help with constipation. Prebiotics help to feed the beneficial bacteria in our guts to support digestion and digestive enzymes help to break down the food in our digestive system. A broad-spectrum multivitamin can also help to ensure adequate nutrient intake throughout your holiday.

Don’t forget your probiotics

Contact with unfamiliar bacteria, changes in time zones, different foods, air travel, dehydration and stress can all affect the healthy balance of our gut bacteria.

Taking live bacteria (probiotic) supplements helps to maintain this healthy balance and they have been shown in research to offer a safe and effective way of helping to prevent traveller’s diarrhea.^[1] They help to reduce the ability of toxins to attach to the gut wall, support immunity through supporting microbiome balance and helping to re-establish a normal gut flora.

Probiotic foods, such as yoghurt and kefir can help and taking a daily high-strength live bacteria supplement before, during and after a trip is a reliable and safe way of supporting the gut. We recommend taking a probiotic supplement for a minimum of a week before you travel and for 1-2 weeks after you return home to provide maximum benefit.

Find a high-strength research-backed probiotic that is lightweight and easy to fit in your case or hand luggage, that all the family can take and that does not require refrigeration (always store in a cool, dry place and be mindful in tropical climates).

Key holiday items to pack to support digestive health

Suggestions to support gut health include probiotics, herbal teabags, magnesium to support relaxation and sleep, digestive enzymes and multivitamins.

It is also worth considering taking a homeopathic first aid kit and arnica cream or oil for bumps, tea tree antiseptic cream for cuts and grazes and aloe vera gel for sunburn and rashes.

Advice for children

Children can follow the same guidelines as adults, including taking a daily probiotic supplement, although young children will need reminding regularly not to drink the local water, particularly when cleaning their teeth or in the shower.

Key take-aways

Before travelling, make a plan – buy some healthy snacks to take with you, find accommodation with a kitchen and start taking your probiotic supplements.

During travel, whilst on holiday – drink only bottled water, focus on healthy foods (including vegetables and fermented foods if you can find them), don’t go overboard with alcohol and you might want to double-up on the good bacteria supplements.

After travelling, when you are back home – get back into your routines, diet and local time-zone as quickly as possible and continue taking your probiotics for at least another week or until you feel that your digestive system is back to normal.

^[1] McFarland, LV. (2007) Meta-analysis of probiotics for the prevention of traveler’s diarrhea. Travel Med Infect Dis 5:97-105