A few weeks ago we asked for your gut-travel questions. Dietitian Laura Tilt is back with the answers.
"Any easy tips for preventing a tricky tummy abroad?"
Experiencing gut health problems when abroad is really common. Traveller’s diarrhoea (TD) affects around 1 in 5 people travelling to high risk destinations. The main culprits are contaminated food or water but this is not the only reason you might experience a change in your gut health whilst travelling. The stress of travel, hot weather, changes to your gut microbiome, dehydration, different foods and drinks, increased alcohol consumption and a change in time zone can all throw your digestion and gut off course.
Here are some tips that can help:
- Optimise your pre-travel diet with lots of different plant foods (try to aim for 30 a week), and prebiotic fibre to feed your helpful gut microbes and strengthen your gut’s defences.
- Set your watch to the time of your destination at the beginning of your journey and get on board with eating and sleeping at the local time as soon as possible.
- Get into the daylight soon after waking at your new destination to reset your body clock - try a walk outside or even sit with a tea in the daylight.
- Avoid too much time in the heat, especially between 12pm and 3pm when it's hottest. Favour the shade and stay well hydrated as dehydration can slow digestion. Be mindful of alcohol intake too; this can irritate the gut and further dehydrate you. Alternate alcoholic drinks with water and try not to drink on an empty stomach.
- Practise good food hygiene and plenty of handwashing or use hand gel.
- Lastly, if you are visiting an area where traveller's diarrhoea is common, read up on how to manage symptoms before you go so that you know what to do if you or any of your travel pals are affected.
"Why do I always feel bloated when I fly? And how can I help it?"Bloating during a flight is due to changes in cabin pressure. As the aircraft climbs, the pressure drops and this causes gases in your body to expand, leading to bloating and discomfort. You also spend a lot of time sitting on a flight which doesn’t help the gas move through your digestive system. The bloating will be temporary but can be uncomfortable. So, here’s what can help:
- If you can, limit foods that are more gas producing in the 24 hours before you fly - these include wheat based foods, apples, broccoli, cauliflower, lentils, beans, garlic and onion.
- When dressing for your flight, choose loose, comfortable clothing that does not restrict your tummy - no tight waistbands!
- Have a light rather than large or heavy meal before flying, and steer clear of chewing gum and fizzy drinks.
- Every hour or so during the flight get up and move around - this is good for circulation but may also assist with moving gas through the gut.
"Every holiday abroad I really suffer, despite being careful, not drinking or brushing teeth with the tap water etc and taking Symprove. What else can I do, as it has got to the stage where sometimes I fear going too far from the hotel or accommodation, just in case I need to use the bathroom."
Lots of things can contribute to an upset gut when you go abroad, from a change in time zone to a different routine, the heat and of course food and drink. You’re taking lots of sensible precautions already and I’m going to cover some extra tips to help manage these factors in a different post, but I wonder if your tummy troubles may be aggravated by anxiety and the gut-brain connection.
To explain: your brain and gut are connected and what happens in one affects the other. So, if you’ve had an upset tummy when holidaying abroad before, you’ll understandably be anxious about this happening again. Anxiety and stress are capable of triggering an upset tummy because they activate the body’s ‘fight or flight’ response, which directly affects digestion. In addition, your brain may go on high alert, interpreting any gut niggles as a sign that you’re about to be unwell, leading you to fear leaving the hotel. All in all this leads to a bit of a vicious cycle.
If this rings true, it’s worth doing a bit of work before you go to try and break this cycle. Relaxation techniques like deep belly breathing can help calm the gut because it activates the part of your nervous system responsible for the relaxation response aka ‘rest and digest’. Try practising daily and once you’ve got that hang of it, you can do a few minutes in those moments where you feel panicked or anxious.
Lastly, if you are someone with irritable bowel syndrome (IBS), both CBT (cognitive behavioural therapy) and gut directed hypnotherapy have been shown to help calm the gut-brain axis and reduce gut distress. Check out Zemedy or Nerva - these programmes are delivered via smartphone over a 6 week period.
"I notice my gut health really suffers in the heat. Do you have any advice for foods or meals to help please? P.S I’ve been taking Symprove for over a year and love it."
Experiencing changes in gut health in the heat may be a combination of factors. First, the microbiome; research has found a link between heat waves and bacterial gut infections likely due to the fact that higher temperatures favour the growth of unfriendly bacteria that cause tummy upsets. On a lesser scale, there could be changes in the gut microbiome that affect your gut health.
During hot weather we also sweat more to stay cool, and this results in blood flow being directed away from the gut to the skin, which can affect digestion. If lost fluids aren’t replaced you may become dehydrated, which can further aggravate gut symptoms and lead to constipation.
So what can you do? Stay well hydrated, remembering that you need to drink more when it's hot. Keep an eye on your urine as a marker of hydration - if it’s dark and strong smelling you need to drink more.
All types of fluid (except alcohol) help to hydrate but you may want to limit caffeine if experiencing loose stools. Alcohol is also a gut irritant so limiting your intake can be helpful. Get into the habit of carrying a water bottle and keep a jug of squash or water with mint and cucumber in the fridge.
Try to stay cool by avoiding midday heat and opting for shade. Try to include some daily movement but keep exercise low to moderate intensity (like walking or yoga for example) in the coolest part of the day.
It’s difficult to recommend food without knowing what symptoms you’re experiencing. Smaller, more frequent meals might be more comfortable (for example eggs on toast, yoghurt and fruit) and try to include good sources of soluble fibre along with plenty of fluid as this will help feed the friendly gut bacteria in your gut, helping them to crowd out the less desirable microbes. Fruits, sweet potatoes, oats, nuts, seeds (including chia) and pulses are good sources.
"What is a good breakfast that doesn’t include dairy or eggs?"I’m guessing you want to know about a good breakfast for gut health so this is my advice: try to include a high fibre food and some fruits or veggies with your breakfast to provide food for your friendly gut bacteria. Adding in some protein or healthy fats will help to keep you feeling fuller longer.
Here are some ideas which include all of these things - minus dairy or eggs.
- Wholemeal sourdough or rye bread toast with nut butter and sliced fruit
- Smoothie with avocado, a frozen banana and dairy free milk alternative (e.g. soy) You could add a handful of leafy greens like spinach for some extra nutrients and a scoop of plant-based protein powder or nut butter for protein
- Scrambled tofu with onions, tomatoes and turmeric on wholegrain toast
- Overnight Chia Pudding: Mix 2 tbsp chia seeds with 1⁄2 cup (125g) of dairy free yoghurt (like coconut or soy) or 1⁄2 cup of dairy free milk in a jar and mix well. Leave in the fridge overnight then top with fresh fruits (or defrosted berries) and a drizzle of nut butter.