The Prevention Guide to Healthy Travel

When you're leaving for vacation, the last thing on your mind is your health. After checking and rechecking lists, packing enough stuff to supply a small army and making arrangements for someone to feed your goldfish, you're probably too exhausted to think about ways to stay healthy away from home.

But after investing so much time and energy (not to mention money!) in your trip, you don't want it ruined by cramps, kinks, rashes, sunburn, injury or assorted bumps, breaks, bugs, bacteria or viruses. And you don't want to come back with more "baggage" (read: pounds) than you had when you left.

Not to worry. Our guide to healthy travel will tell you how to eat well, avoid stress, stay safe and travel comfortably, no matter where you're headed or how you plan to get there.

Get there quickly and safely

Flying is fast and convenient, but as any frequent flier knows, air travel comes with its own set of aggravations. To make your flight more enjoyable, try these tips:

Distribute your luggage among two smaller suitcases instead of one large one, says Edward N. Hanley Jr., MD, chairman of the department of orthopedic surgery at Carolinas Medical Center in Charlotte, NC. This will help you balance the weight while carrying your bags through the airport. Better yet, wheel your luggage.

Check all bags that are heavier than five to ten percent of your body weight. When stowing your carry-on luggage, stand straight and away from the overhead compartment, suggests the American Chiropractic Association. Whenever possible, place heavier bags under the seat in front of you to avoid having to lift them over your head.

Before you buckle up, place a small airplane pillow or inflatable lumbar support in the gap between your lower back and the seat. This will counteract the tendency to slump and decrease the risk of in-flight back pain.

Don't cross your legs. It shortens the leg muscles, reduces circulation and creates an uneven weight on the hips and pelvis, which can cause lower-back pain.

Rest your feet on a briefcase or carry-on bag placed on the floor. This will bring your knees above your hips to take the pressure off your lower back.

Get up and move around. Studies show that sitting motionless for several hours, whether in a plane or a car, increases your risk of developing deep vein thrombosis (DVT), a condition in which blood clots form in your legs. In rare instances, the clots can be fatal.

(Know the signs: Travel-related blood clots in veins will cause pain in the leg or chest. Even if these symptoms arise a few days to four weeks after trip's end, see your doctor.)

To minimize the risk of developing DVT, walk (or at least stand) once every two hours. At your seat, point your toes down (heels up), then raise your toes up toward your knees so that you're flexing your calf muscles, suggests Rebecca W. Acosta, MPH, executive director of Traveler's Medical Service in New York City. Bonus: Standing upright will also reduce strain on your lower back.

Say no to the airline snack packs. Instead, pack fruit, a whole wheat bagel or other healthy treats. Or buy some fruit and yogurt or a smoothie at the airport before you board the plane.

Wear loose-fitting clothing, and pack a pair of slippers or thick socks in your carry-on bag for your feet, says Acosta. For longer flights, bring along an inflatable pillow for your neck in case you plan to nap. It folds flat and packs easily in your carry-on bag.

Bring a liter bottle of water with you, especially on flights of two hours or more, says Acosta. It takes a lot of water to stay hydrated on a plane, where the air is very dry. Alcohol only makes you more dehydrated, so steer clear of the cocktail cart. Dehydration causes headaches and makes the symptoms of jet lag worse. Drinking lots of water has an added benefit: It forces you to get up and use the bathroom, which keeps you -- and your blood -- moving.

Flying across time zones? Don't let jet lag ruin your vacation, says Acosta, who recommends a few commonsense tips: If you're flying at night, ignore the overhead movies and get some shut-eye if you can. Ask your doctor about a mild sleep aid, especially if you're on a flight of eight hours or more, she suggests. (One downside is that this can make you too groggy to deal with delays and emergencies.) Upon arrival, spend as much time outdoors as possible during the daylight hours; this helps in the adjustment process. Take a short nap (no more than 30 minutes) if you're feeling sleep deprived.

How to survive the drive

There are two kinds of people in this world: those who think driving across five states is a great way to see the world, and those who would rather have a tooth extracted without novocaine than endure long hours of bad radio, cramped space and the world's worst food options. We can't help you with the radio, but we can tell you how to eat better and feel more comfortable on long car rides.

Whether you're traveling by turnpike or freeway, unhealthy food awaits you at every exit and rest stop. "Yet if you eat healthfully on the road, then a lot of other things that go along with travel, such as stress, fatigue and poor sleep, can be prevented," says Somer. "By fueling your body with healthy foods, you'll have more energy and be more alert. You may even sleep better if you're not drinking coffee and soda along the way," she says.

And if you're careful about how long you drive and you maintain proper driving posture, you'll arrive at your destination without feeling like you've been packed into your own luggage. Here's what to do:

Pack an ice chest with small, nutritious snacks such as baby carrots, fruit, peanut butter on whole wheat bread and yogurt. Throw in some bottled water, orange juice or 1% milk.

If fast food is your only option, stay away from fried items and fatty accompaniments such as mayo and oily dressings. Grilled chicken sandwiches are okay if you tell them to hold the mayo. Ordering a salad? Go easy on the dressing, or order a light dressing.

If you're leaving in the morning, pack your car the night before. Fluids pool in your spinal disks while you sleep, making your lower back taut and sensitive to irritation when you first wake up.

Before getting in the car, take a short walk to loosen your leg muscles, and be sure to stretch, advises the American Chiropractic Association. Long trips should be treated like an athletic event.

To minimize driver fatigue, stop every two to three hours (make it every two hours if you're traveling with children) to stretch and walk around, advises Acosta.

Use a back support. The widest part of the lumbar support pillow should be between the bottom of your rib cage and your waist. You can find a wide variety of back supports designed for car use in stores and online.

Tilt your rearview mirror up a little bit. This will help your posture by making you sit up straighter to see out the back window. You should still be able to see clearly out the back.

Rules for your home away from home

By the time you reach your hotel or motel, you might be feeling a little stressed or run-down. That's not good for your health: Stress suppresses the immune system, making you more vulnerable to the germs you encounter along the way.

Vacation is about relaxing, and you don't want to start it with the sniffles -- or worse, a full-blown cold. Yet that's what often happens to travel-weary vacationers, says Douglas Schar, DipPhyt, MCPP, MNIMH, a clinical herbalist based in Washington, DC. Here's how to protect yourself from illness, get a good night's sleep and get out of the hotel without spending more on the fat-filled goodies in the honor snack bar than you do for the room:

Take echinacea, says Schar. Echinacea is an herb that boosts the immune system by stimulating the production of infection-fighting white blood cells. Start taking it five days before you leave for vacation, and continue for five days after your return. Dosage: one teaspoon of 1:5 tincture three times daily, or one 500-mg tablet three times daily.

Pack chamomile tea bags. Chamomile can help take the edge off a stressful journey by relaxing a tense mind and sore muscles, according to Schar. It also has a sedative effect, so you'll be able to get a good night's sleep.

Bring your own pillow or blanket if you have trouble sleeping in "foreign" beds. That little touch of home can help.

Be safe: Upon arrival, inquire about fire exits, alarms and sprinkler systems, says Acosta. Always lock your door, and avoid first-floor rooms, which are too easily accessible from outdoors.

It's tempting, but don't open that refrigerator in your room, advises Somer. It's filled with fatty, overpriced snacks. Instead, cover it with a towel, and take a walk to a nearby grocery store to stock up on fruit, baked tortilla chips and salsa, and other healthy treats.

Be picky with the room service menu. "Don't assume that what's on the menu is all that you can have," says frequent traveler Somer. Hold the fluffy white roll, and ask for a big plate of steamed vegetables to accompany grilled chicken or fish. Order just enough to be comfortably full, not stuffed.

Stay fit. Most hotels and many motels now have fitness facilities, including swimming pools. If you don't want to spend precious vacation time in your hotel gym, get out and try something new. Depending on where you're staying, you might want to try inline skating or kayaking, or you can just rent a bike or go hiking.

Ship out in good shape

Sunshine, good food, nightly entertainment and stops in colorful ports along the way -- it's not hard to figure out why cruises are so popular. But before you set sail, take along a few simple strategies for staying well on the high seas.

Cruise ships are basically floating buffets. If you must sample every calorie-rich food on the table, try filling your plate first with steamed vegetables and a salad. Then take one or two bite-size portions of the creamy/ buttery/fried stuff.

Take ginger for motion sickness. Research has shown that ginger beats dimenhydrinate, the main ingredient in many motion-sickness drugs, such as Dramamine. Dosage: two 500-mg tablets three times daily, or one teaspoon of 1:5 tincture three times daily.

Protect winter-white skin with sunscreen (SPF 15 or higher), and try to avoid direct sunlight between 10am and 4pm, when the sun's rays are strongest. "Too often, vacationers will get on a cruise ship headed for the Caribbean, sunbathe for 8 hours on the first day with little or no sunscreen and end up with a severe burn," says Grant Tarling, MD, senior ship's doctor for the Los Angeles-based Princess Cruises.

Look into your medical insurance plan before you leave home. If your plan covers you outside the U.S. (many, including Medicare, don't), carry a copy of your policy and your insurer's phone number. Otherwise, consider purchasing some additional travel medical insurance, Dr. Tarling says. This applies to any form of travel outside the U.S. and, sometimes, even out of state.

Whether you're exploring the Grand Canyon, lounging by Lake Michigan or parasailing in Cancun, don't leave home without a well-stocked medicine kit, advises Mary D. Nettleman, MD, an infectious disease specialist and professor of medicine at Virginia Commonwealth University in Richmond. Here's her list of must-haves:

Prescription medications. Keep them in your carry-on luggage, and always bring more than you need. Leave all medicine, both prescription and over-the-counter (OTC), in the original container. This is especially important if you'll be passing through a customs checkpoint.

Cold remedies. Don't forget cough drops and tissues.

Insect repellents. If you'll be traveling to a country where malaria is a risk, pick one that contains DEET, and consider insecticide room sprays and mosquito nets.

Sunscreen and lip balm. Choose SPF 15 or higher. You may also want to include topical cortisone cream for rashes and bites and body lotion containing aloe to soothe burns.

Foot care products. Include Band-Aids and pads to protect blistered feet from further damage.

For women only: sanitary napkins/tampons. If you're traveling abroad, include medication for vaginal yeast infections.

Diarrhea remedies. If you're traveling to a developing country, take along loperamide or Lomotil. Ask your doctor about a prescription antibiotic to be taken at the first sign of diarrhea.

Miscellaneous items. These include aspirin, acetaminophen or other OTC pain relievers, bandages, gauze, adhesive tape, tweezers, scissors, laxatives and a thermometer. If you're traveling to a Third World country, you may want to include a needle and thread, safety pins, matches, a flashlight, toilet paper and moist towelettes.

QUICK TIPS:

Apply cool aloe gel to sunburned skin. Besides pain relief, there's some evidence that aloe can reverse some of the damage caused by the sun's ultraviolet rays, says herbalist Douglas Schar. Read labels to make sure you get the real thing. Aloe gel is clear (not green).

For vaccination and disease information for adventure travel, visit the Website of the Centers for Disease Control and Prevention (CDC), which provides information by vaccination type and destination.