By Rick Steves
Using discretion and common sense, I eat and drink whatever I like when I'm on the road. I've stayed healthy throughout a six-week trip traveling from Europe to India. By following these basic guidelines, I never once suffered from Tehran Tummy or Delhi Belly.
Take precautions on the flight. Long flights are dehydrating. I ask for "two orange juices with no ice" every chance I get. Eat lightly, stay hydrated, and have no coffee or alcohol and only minimal sugar until the flight's almost over. Avoid the slight chance of getting a blood clot in your leg during long flights by taking short walks hourly. While seated, flex your ankles and don't cross your legs. Some people are more prone to clots (factors include obesity, age, genetics, smoking, and use of oral contraceptives or hormone replacement therapy).
Eat nutritiously. The longer your trip, the more you'll be affected by an inadequate diet. Budget travelers often eat more carbohydrates and less protein to stretch their travel dollars. This is the root of many health problems. Protein helps you resist infection and rebuilds muscles. Get the most nutritional mileage from your protein by eating it with the day's largest meal (in the presence of all those essential amino acids). Supplemental super-vitamins, taken regularly, help me to at least feel healthy.
Use good judgment when eating out (and outside Europe). Avoid unhealthy-looking restaurants. Meat should be well cooked (unless, of course, you're eating sushi, carpaccio, etc.) and, in some places, avoided altogether. Have "well done" written on a piece of paper in the pertinent language and use it when ordering. Pre-prepared foods gather germs (a common cause of diarrhea). Outside of Europe, be especially cautious. When in serious doubt, eat only thick-skinned fruit...peeled.
Keep clean. Wash your hands often, keep your nails clean, and avoid touching your eyes, nose, and mouth. Hand sanitizers, such as Purell, can be helpful. However, since they target bacteria, not viruses, they really should be used as an adjunct to, rather than a replacement for, hand washing with soap and warm water.
Practice safe sex. Sexually transmitted diseases are widespread. Obviously, the best way to prevent acquiring an STD is to avoid exposure. Condoms (readily available at pharmacies and from restroom vending machines) are fairly effective in preventing transmission. HIV is also a risk, especially among prostitutes.
Exercise. Physically, travel is great living — healthy food, lots of activity, fresh air, and all those stairs! If you're a couch potato, try to get in shape before your trip by taking long walks. People who regularly work out have plenty of options for keeping in shape while traveling. Biking is a great way to burn some calories — and get intimate with a destination. Though running is not as widespread in Europe as it is in the US, it's not considered weird either. Traveling runners can enjoy Europe from a special perspective — at dawn. Swimmers will find that Europe has plenty of good, inexpensive public swimming pools. Whatever your racket, if you want to badly enough, you'll find ways to keep in practice as you travel. Most big-city private tennis and swim clubs welcome foreign guests for a small fee, which is a good way to make friends as well as stay fit.
Get enough sleep. Know how much sleep you need to stay healthy (generally 7–8 hours per night). If I go more than two nights with fewer than six hours' sleep, I make it a priority to catch up — no matter how busy I am. Otherwise, I'm virtually guaranteed to get the sniffles.
Give yourself psychological pep talks. Europe can do to certain travelers what southern France did to Vincent van Gogh. Romantics can get the sensory bends, patriots can get their flags burned, and anyone can suffer from culture shock.
Europe is not particularly impressed by America or Americans. It will challenge givens that you always assumed were above the test of reason, and most of Europe on the street doesn't really care that much about what you, the historical and cultural pilgrim, have waited so long to see.
Take a break from Europe, whether it's a long, dark, air-conditioned trip back to California in a movie theater; a pleasant sit in an American embassy reading room surrounded by eagles, photos of presidents, Time magazines, and other Yankees; or a visit to the lobby of a world-class hotel, where any hint of the traditional culture has been lost under a big-business bucket of intercontinental whitewash. It can do wonders to refresh the struggling traveler's spirit.
Basic First Aid
Be proactive to stay well. If you do get sick, take action to regain your health. (See my list of first-aid items to pack from home.)
Headaches and Other Aches: Tylenol (or any other over-the-counter pain reliever) soothes headaches, sore feet, sprains, bruises, Italian traffic, hangovers, and many other minor problems. If you're buying it overseas, Europeans may be more familiar with the term "paracetamol" (pare-ah-SEET-ah-mall).
Swelling: Often accompanying a physical injury, swelling is painful and delays healing. Ice and elevate any sprain periodically for 48 hours. A package of frozen veggies works as a cheap ice pack. If your foot or leg is swollen, buy or borrow a bucket and soak the affected area in cold water, or sit on the edge of a cool swimming pool. Take an anti-inflammatory drug like ibuprofen (Advil, Motrin). Use an Ace bandage to immobilize, reduce swelling, and provide support. It is not helpful to "work out" a sprain — instead, cut back on activities that could aggravate the injury.
Fever: A high fever merits medical attention. A normal temperature of 98.6° Fahrenheit equals 37° Celsius. If your thermometer reads 40°C, you're boiling at 104°F.
Colds: It's tempting to go, go, go while you're in Europe — but if you push yourself to the point of getting sick, you've accomplished nothing. Keep yourself healthy and hygienic. If you're feeling run-down, check into a good hotel, sleep well, and force fluids. (My trick during the hectic scramble of TV production is to suck on vitamin C with zinc tablets.) Stock each place you stay with boxes of juice upon arrival. Sudafed (pseudoephedrine) and other cold capsules are usually available, but may not come in as many varieties.
Abrasions: Clean abrasions thoroughly with soap to prevent or control infection. Bandages help keep wounds clean but are not a substitute for cleaning. A piece of clean cloth can be sterilized by boiling for 10 minutes or by scorching with a match.
Blisters: Moleskin, bandages, tape, or two pairs of socks can prevent or retard problems with your feet. Cover any irritated area before it blisters. Many walkers swear by Body Glide, a solid anti-chafing stick sold in running shops and sporting-goods stores. For many, Band-Aid's Friction Block stick is a lifesaver for preventing blisters in spots where your shoe rubs against your foot.
Motion Sickness: To be effective, medication for motion sickness (Dramamine or Marezine) should be taken one hour before you think you'll need it. These medications can also serve as a mild sleep aid. Bonine also treats motion sickness but causes less drowsiness.
Diarrhea: Get used to the fact that you might have diarrhea for a day. (Practice that thought in front of the mirror tonight.) If you get the runs, take it in stride. It's simply not worth taking eight Pepto-Bismol tablets a day or brushing your teeth in Coca-Cola all summer long to avoid a day of the trots. I take my health seriously, and, for me, traveling in India or Mexico is a major health concern. But I find Europe no more threatening to my stomach than the US.
I've routinely taken groups of 24 Americans through Turkey for two weeks. With adequate discretion, we eat everything in sight. At the end of the trip, my loose-stool survey typically shows that five or six travelers coped with a day of the Big D and one person was stuck with an extended weeklong bout.
To help avoid getting diarrhea, eat yogurt, which has enzymes that can ease your system into the country's cuisine.
If you get diarrhea, it will run its course. Revise your diet, don't panic, and take it easy for 24 hours. Make your diet as bland and boring as possible for a day or so (bread, rice, boiled potatoes, clear soup, toast without butter, weak tea). Keep telling yourself that tomorrow you'll feel much better. You will.
If loose stools persist, drink lots of water to replenish lost liquids and minerals. Bananas are effective in replacing potassium, which is lost during a bout with diarrhea.
Don't take antidiarrheal medications if you have blood in your stools or a fever greater than 101°F (38°C) — you need a doctor's exam and antibiotics. A child (especially an infant) who suffers a prolonged case of diarrhea also needs prompt medical attention.
I visited the Red Cross in Athens after a miserable three-week tour of the toilets of Syria, Jordan, and Israel. My intestinal commotion was finally stilled by a recommended strict diet of boiled rice and plain tea. As a matter of fact, after five days on that dull diet, I was constipated.
Constipation: With all the bread you'll be eating, constipation, the other side of the intestinal pendulum, is (according to my surveys) as prevalent as diarrhea. Get exercise, eat lots of roughage (raw fruits, leafy vegetables, prunes, or bran tablets from home), and everything will come out all right in the end.