How to Travel Without Hugging the Bowl: 10 Tips for Staying Healthy on the Road


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The first person to utter “shit happens” must have been a traveler.

As I emptied myself from both ends for the better part of 36 hours in the hills of northern Ecuador recently (a bad batch of cevichochos, I suspect), I was reminded that we owe our readers an accounting of how we usually manage to stay healthy while we travel.

Travel Health Tips, Eating Safely
Market stall tofu in Yuanyang, China.

Fortunately, Audrey and I have each only endured stomach bugs three or four times in the last few years of travel — in places like Vietnam, Uzbekistan, Kazakhstan, Guatemala, and most recently for me, Ecuador.

You ate on the streets in Burma and never got sick? All that food in China and never sick? India even?

Yes. That's correct.

If you follow us, you know that we rarely deny ourselves the joys of exploring local street food and meals in hole-in-the-wall restaurants. And although it appears that we eat with reckless abandon, we do tend to follow some basic guidelines. These are not hard and fast rules (we do break them sometimes) but a philosophy and approach that seem to work for us. The idea is to sharpen our ability to size up eating situations while balancing the reward of authentic local dining with the risks of becoming ill.

Tips for Staying Healthy, in no particular order

1. Wash your hands often.

Then wash them again. Not to sound obsessive-compulsive, but get into the habit of washing your hands before a meal, after a meal and any time you think of it, particularly if you have been holding railings on public transportation or shaking hands at the local market. And don't skimp on the soap. Carry a tube of anti-bacterial gel for those rare moments when no soap or sink is available.

2. Beware of tempting fruit shakes and drinks made with unpurified water.

Those stands may look so good in India, but don't risk buying a fruit shake off the street unless you are certain the water (or ice!) has been purified. There's no need to completely deny yourself this pleasure, but just ask first or order it from a tourist-oriented restaurant that has purified water clearly marked on the menu.

During my first visit to India, an Indian-American friend asked his father why he cautioned against drinking sugar cane juice from a street stall. “There!” his father pointed to a giant block of ice being wheeled down the street on a cow cart lined with poop-stained burlap.

3. Cooked is more reliable than fresh.

If you have questions about the hygiene of what and where you're eating, make sure everything is properly cooked. Fried, boiled, or baked, high temperatures kill germs.

Travel Health Tips, Eating Street Food Safely
Cooking lessons in Varanasi, where Audrey cooks everything thoroughly.

When in doubt, avoid the street food dishes with fresh herbs on top. Sure, in places like Thailand and Vietnam, you are probably OK. We also ate loads of fresh herbs in Burma. The point is that we didn't wholesale avoid them; we made decisions based on the environment.

Same goes for mayonnaise toppings. Assume no refrigeration.

4. When in doubt, take it easy on the meat.

Meat insidiously turns faster and meaner than vegetables ever will. You never know how meat has been handled or how long it has stood before it lands in your mouth…and your stomach.

We are certain that leaning vegetarian helped us stay healthy in India and China. Did we eat meat in both countries? Yes, but only when the signs were favorable. In India, we usually reserved meat for spiffy-looking street stalls and formal restaurants that were certain to have refrigeration.

5. Spice is your friend.

I have no scientific proof that chili sauce kills bacteria, but I'm inclined to believe that our copious use of hot sauces have served our stomachs well prophylactically. Although the argument continues, some say that good ‘ol black pepper was traditionally used as a preservative.

Travel Health Tips for Eating Safely
Spicy goodness. Chili pepper paste from Kyrgyzstan.

6a. A little bacteria is a good thing.

We're big believers in maintaining a healthy layer of good bacteria in our stomachs. Experiment a little bit when you travel so that you build up some resistance. If you are a first-time traveler and are accustomed to everything antibacterial and antiseptic, the world overseas will find a way to shock your system. You are likely to experience an adjustment.

So consider keeping things clean, but don't sanitize everything you touch – living in an anti-bacterial world can put you at risk when you leave the bubble.

6b. Learn to like yogurt.

When fighting bad bacteria, make sure you have enough “good” bacteria inside of you. Some people carry probiotics or acidophilus pills to balance and replenish good bacteria. I just like to eat yogurt, particularly the fresh, unpasteurized stuff. The top of the yogurt hierarchy is the homemade stuff (matsoni) from the mountains of Georgia. It just felt healthy.

7. Look for high turnover and low fly-count.

Seek out street stalls and restaurants with a high turnover of food. Freshly cooked is better than something that's been sitting around on a tray for a while. The longer food sits, the more likely it will play host to bacteria. High turnover also implies high traffic, which itself suggests that the food being served is probably pretty good.

Eye the fly-count. Flies are excellent carriers of disease.

8. Check your glass and silverware.

Don't obsess, but give it the once-over. It may be better to drink your soda or beer directly out of the bottle than from a glass (or wipe the glass if you must). Or ask for a straw to drink fruit juices or sodas. Run a napkin over your utensils or ask for a new set if they look unappetizing. Or consider heading somewhere else where the silver is, um, a bit cleaner.

9. Peel your fruits and vegetables.

When everything you eat is cooked, you will crave fresh fruits and vegetables. Buy the kind you can peel – bananas, cucumbers, carrots, papayas, avocados, etc. Avoid lettuce or anything with a skin you eat (e.g., tomatoes). If you do, wash them in purified (and slightly chlorinated water).

Travel Health Tips, Avoid Peeled Fruit
Fresh fruit. Looks so good, but not always good for you.

If you venture to eat cut fruit (see the image above), be mindful of toppings that might be made from unpurified water.

10. Don't let your guard down on organized tours.

Ironically, half of our stomach episodes have occurred on organized treks, once in Vietnam and again in Guatemala. Having assumed the organizers had taken all the necessary precautions, we ate fresh vegetables we would have otherwise avoided. Likely a dirty knife in one case and a dirty mango skin in the other. And we paid for our lapse in judgment.

Honorable Mention: Good old-fashioned luck of the draw.

Although we do not recommend relying on pure luck, it bears mentioning that you could throw caution to the wind while traveling, eat on the street 24-7 and never get sick. Likewise, you can follow every healthy travel eating guideline and spend more than your fair share of time in the toilet.

Basically, it's a crapshoot.


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How to Stay Healthy While Traveling

About Daniel Noll
Travel and life evangelist. Writer, speaker, storyteller and consultant. Connecting people to experiences that will change their lives. Originally from the U.S. Daniel has lived abroad since 2001 and most recently has been on the road since 2006. When he's not writing for the blog you can keep up with his adventures on Twitter, Facebook, and Instagram. And you can learn more about him on the About Page and on LinkedIn.

102 thoughts on “How to Travel Without Hugging the Bowl: 10 Tips for Staying Healthy on the Road”

  1. Super article! I can’t agree with you more. I been traveling for about 3 years and have only been really sick once – and I eat everything. Sure, I think I’ve built up a good resistance to bacteria by this point – but it’s all about luck and a little common sense. You’ve done a fabulous job of laying it out here!

    Reply
    • make sure you check food websites for restaurant recommendations – places that are full are often full due to their POSITION, – good views which draw a crowd don’t guarantee good food.

      Reply
      • Your observation goes well for tourist restaurant. The article clearly is aimed at the more adventurous eater. I would add two observations on this great article:
        1. Wherever you travel, seek out the food the locals know how to prepare
        2 Eat where the hotel/restaurant staff eats.
        3. Stay in general away from pork.

        Reply
        • Excellent suggestions all, Thor. Thank you. Good idea on staying away from pork as a general digestive health precaution. The two other suggestions to eat what locals know how to make and to follow the restaurant staff is not only good for health, but also better for one’s local eating experience.

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  2. Thanks for this great article! This is something I dread, being ill for 36hrs. But, it makes sense that you don’t want to live in a bubble and not experience the culture. Just do it intelligently. I am going in with the attitude that we will get sick, it’s just a matter of when. However, now we can try to minimize it.

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  3. Great article! I am blessed with an iron stomach… or maybe it’s the fact that I’m not that big of a foody. I like the iron stomach explanation though and can only think of one time in Burma where I ever had a non-hangover-related barf. I think that was due to my malaria medication though.

    I think it’s those unpurified water ice drinks that have made me strong. I can never resist! A more likely possibility is the ice they used in Haiti. They carry HUGE blocks of the stuff through the dusty streets in wheelbarrows and would chop off a bit, run it under some well water and put it in your drink with their bare hands. If that doesn’t make a person invincible, I don’t know what will.

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  4. I can’t imagine not drinking the fresh fruit juices in many of the places I’ve traveled. Great tips to ease people in so they can enjoy the cultural cuisine that makes a place special.

    Another addition to your list is simiar to tip #7. I watch where the locals eat. This not only guarantees a high turnover of food but also says something about the trust locals put into what they are eating.

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  5. Great article. The other thing that we always do is to make sure we wash our toothbrush with filtered water. I am usually pretty careful about the food we eat (too many bouts of food poisoning in India) but I always forget about the water that hits my toothbrush.

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  6. Very logical and practical advice. All behaviors I have been following for years, but like you say, sometimes it’s the luck of the draw. I have taken a chance here and there, an no problems, but have let my guard down in a nice hotel and…bam!

    Bon Appetit

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  7. I must admit I was a little freaked out by the scary tweets about your latest sickness and how often you guys have gotten ill. We are older and have a young child, so are even more careful with food. We are headed to Africa and South America next, so it caught my attention.

    In my 20’s I ate raw clams in Haiti and steak tartar in Mexico City ( both at very high end hotels) , but got hepatitis at the first and very sick at the other, so learned some caution the hard way. Also just learned about a friend who vacationed in Buenos Aires and got Mad Cow disease that slowly killed him painfully.

    So many get sick in Morocco even in good places, but we were extremely vigilant ( our child was just 6) and did not have a problem even though we did a camel trek deep into the Sahara and stayed in some off the track places ( one very primitive one made out of mud!) and hung out in local berber homes ( with no running water).

    I am also a nurse and our child has never had a vaccine in her life ( she does have natural immunity to much including hepatitis thanks to my experiences and long term breast feeding), so probably a little more cautious than most.

    Not only is cooked food important, but HOT cooked food is essential. If it has been cooked but sitting out, you can still get sick.

    The orange juice looked so tempting in Morocco, but we have heard that sometimes they add contaminated water to it behind the scene ( to make more money, not realizing they are putting people at risk). Some things that don’t get the locals sick ,will get you sick!

    A friend told me how he got deathly ill on watermelon in India ( hard skin) because it turns out they sell by weight. To make more money it is common to add bad water to watermelons by syringe to get more money for them. Again, not intentionally trying to get anyone sick, just poverty playing it’s role.

    I don’t think it is all luck. If you make wise choices in highly suspect places, you have a much higher chance of not getting sick.

    It really boils down to common sense, doesn’t it? I have a very skinny kid who can not afford to lose a pound, so I can’t take the same chances I could when young. So far, 3 years, 4 continents, over 100K miles ( most by land) of our world tour, we have not gotten sick, but once.

    Hubs ( without me) forgot the golden rule of never buying open drinks in risky places and bought her a lemonade in Istanbul. She spent the night vomiting all over us. Thankfully, she was better the next day.

    I am determined to make that our last encounter of travelers diarrhea! Good luck to you guys. Stay well!

    Reply
  8. As a traveller with a medical background – I’m thrilled to see such practical advice. You’re right to point out the ‘luck of the draw’ element, though. I survived India but not Washington DC.

    However I’m confident that everything would have been much worse had I not followed the kind of advice you mention above.

    Hope you feel better soon…

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  9. Agree 100% with not becoming too sanitized. building up a resistance is the best defense in our opinion. An another great piece of advice is to not let your guard down. I made it all the way through Peru eating street meat, and eating in small diners. But I didn’t get sick until we were back in Lima and decided to splurge at on a hamburger at Tony Romas. I was throwing up for days and the entire flight home! I don’t even normally eat hamburgers. I was just craving one that day. Big mistake.

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  10. As an India traveler who has been mostly lucky over there, I think you’ve covered all the bases for staying healthy in the third world. I try to make fruits that are peeled (like oranges) a staple. It can be OK to buy cooked food from a street vendor, but only if you can watch him cook it with your own eyes. Can not trust them in any other circumstance. I have a friend who became extremely ill from street vendor food.

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  11. Just had the chance to catch up on this. Glad you are feeling better and what a great post. We haven’t had any problems here in Brazil, but will be putting your tips into practice when we travel SE Asia in October. Thanks!

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  12. Thanks everyone for the comments…and the concern about my health. As for the last episode, it was 36 hours, up and out. And as for the previous episodes, they were light and in total took no more than 48 hours to find their way out. Fortunately, doctor’s offices and hospital visits have not made it into our exploration of the world.

    Looks like the consensus is somewhere between luck and common sense. I also like that a number of people mentioned the fact that “nice” restaurants can deliver bad experiences. I’ve seen some kitchens at “good” restaurants that look like horror-shows and we know many travelers who got sick at “reputable” places in capital cities when they let their guard down.

    @Akila: When we were in India last year, I considered doing the same thing, but adopted the belief that a little bit of water on my toothbrush might help build my immunity rather than crush it. I think it was a matter of good fortune that the faucet water on my toothbrush never found its way to my tummy.

    @Kirsty: “Non-hangover-related barf.” Still laughing about the choice of words. Unpurified water and food is a double-edged sword. I think it builds immunity. But if you get an amoeba, I don’t think there’s an iron stomach in the world that could beat it. Though well water in Haiti sounds like it builds character.

    @Pete: I’m glad someone actually read all the way to the end! Glad you appreciated the pun.

    @JoAnna: I can’t imagine not drinking fruit juices either. However, not all fruit juices (and local water) are created equal. We drank them off the streets in SE Asia all the time. However, put me in a small village in India and I would be thinking twice.

    @soultravelers: Thanks for your concern. Given that we’ve been eating on the street in developing countries for the last three years, I thought we were doing pretty well with being able to count our sick episodes on one hand!

    One does have to be extra careful with children and it’s more tricky when you don’t have access to a kitchen and are at the mercy of local restaurants. But, as your experience proves it is possible to eat healthy on the road with kids. Audrey spent her early years growing up in Sub-Saharan Africa and South Asia and doesn’t have memories of getting sick.

    @Anil: Next to air and water, yogurt is a force of life. We met someone recently who went so far as to say “…whenever I get sick, I eat yogurt.”

    @Abigail, Dave and Deb: Proving once again that “nice” restaurants and chain restaurants are not always safe.

    @Steven: Thanks. Let’s just say the latest experience was fresh in my mind when it came to titling this piece.

    @Lori: SE Asia strikes me as one of the more hygenic regions we’ve traveled. Have fun and enjoy the food.

    Reply
  13. Being sick on the road is horrible, and I don’t wish it on anybody. Having said that, living in an anti-bacterial sterile world and avoiding just about everything the locals do is no way to truly experience travel either.

    My boyfriend and I managed to stay in Thailand for almost 5 weeks, eating street food and drinking tap water (albeit sterilized with a steri-pen) absolutely every day. Not once did we get sick.

    We did, however manage to get a neurological disease (score! Our first tropical disease!) in Hawaii from eating fish that we caught ourselves, and my boyfriend suffered from Dengue fever in Thailand. I’m considerably more worried about the mosquitoes now wherever we go than the food. After a week of toying with death in a hospital bed, “once BITTEN twice shy” is an adage that comes to mind.

    Your tips are a fabulous summary of just how to avoid as much of the bad stuff as you can, while still enjoying all the good stuff there is to be had. Thanks!

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  14. @Alastair: Thanks.

    @Nora: Love the street food in Thailand. One of the best places to enjoy street food that we’ve experienced.

    Very sorry to hear about your boyfriend’s dengue fever experience. I contracted it on my first trip to India 10 years ago and can say without equivocation that it’s the worst I have ever felt in my life.

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  15. I recall the four “F”s of field sanitation…food+fingers+flies+feces = pain and agony. I agree with the organized tour thing. Spent sixteen hours leaking from both ends on our honeymoon in Mexico. Should have followed my instincts and skipped the salad at the traditional Mayan village.

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  16. Thanks for this post; definitely useful advice when traveling to countries with less-than-sparkling conditions.

    I suppose a lot of the time people are so used to their home environment that they forget that not all water that comes out of the tap is drinkable, or that people forget to wash their hands and prepare your (raw) food… etc. Erring on the side of caution is a fantastic idea, while making sure that you get the chance to sample local delicacies. 🙂

    Once again, thanks for the great tips!

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  17. @tom: “Leaking”…now that sounds really unpleasant, slow and drawn-out. Any field sanitation guides laying around? Sounds like just the kind of advice we’re going to need for upcoming visits to traditional Incan villages.

    @Mary: Like Tom’s field sanitation guides…the idea is to be aware of your environment, particularly when it changes.

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  18. These are great tips for travelers! Regarding comment #6b, while yogurt can provide you with good bacteria, it doesn’t contain enough of them to truly help fight bad bacteria. One of the most frequent ailments of traveler’s is traveler’s diarrhea (TD), and anyone who has had it knows that it can wreak havoc on your stomach. To help guard against traveler’s diarrhea, try a probiotic supplement like Florastor. Florastor, which contains a beneficial yeast called Saccharomyces boulardii, will naturally help ward off pathogenic bacteria (from food, water, etc.) that can cause TD or other intestinal upset. It’s also very convenient because it’s sold in a 20 capsule blister pack and it doesn’t have to be refridgerated like some other probiotic supplements.
    [duplicate link removed]

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  19. Great article,

    It’s also not a bad idea to consider vaccinations for Hepatitis A, Typhoid and Cholera (some areas) before departure. Hepatitis A is a series of two shots that once you complete, can last 20-30 years, potentially life time cover – ideal if you plan on travelling in the future!
    Also important to consider a ‘post travel’ consultation with a specialised travel medicine specialist if you have syptoms that continue well after initial problems.

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  20. Great advice! We have found that fresh street food it by far fresher & hygenic than many touristy restaurants. When in doubt, go with your gut 🙂

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  21. @Clare: Great advice. Proper vaccinations are must, whether or not you intend to eat street food. As for the post-travel consultation, good idea — provided your trip doesn’t last three years. Reminds me of a friend who got a bacteria in India. He returned to San Francisco (after losing 30 pounds). When the hospital did a culture, the doctors were amazed and gathered around because he had a bacteria that none of them had ever seen.
    @Tracy: Even high-end restaurants have horror show kitchens. And “touristy” restaurants are a guarantee of nothing more than a big bill and an expectation of a big tip. “Go with your gut.” Love it. Very clever — pun intended, I’m sure.

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  22. You are right about the ice drinks, they’re not made with bottled water. The only time I ever got sick after 10 years of traveling was after drinking a lychee ice drink at a Pizza hut in China. I suspect that the ice and the water were made with contaminated water.

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  23. great travel tips! I have been lucky enough that I havn’t gotten sick while abroad, but I am a big believer of eating local! the local fair is what the people of the area know how to make best. for example the poor gal who got sick from a pizza hut in China … case in point, Pizza Hut in China! should have stuck with the fried rice and broccoli beef.

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  24. @anne: Maybe it was pizza hut, or maybe it was just luck (you know, the law of averages). But big restaurants and chain restaurants are not always the most reliable in terms of hygiene, particularly if the comments on this post are any measure.

    @AC: I know, “Why eat Pizza Hut in China?” I probably wouldn’t do it myself, but I have enjoyed a Subway sub in Beijing. Why? As much as we love real Chinese food (all of it: https://uncorneredmarket.com/demystifying-food-in-china/), it was time for a break. Anyhow, the lesson: eater beware…the cleanest-looking places aren’t always the most hygienic.

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  25. I was peeling (Rule #9) an apple from the countryside here in Afghanistan and thought I better re-read this article. I am working on #5 & #6. #4 is a good reminder. Thanks again for the wisdom.

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  26. @Steven: You are quite welcome. Thanks for checking in. Apples in Afghanistan — sounds like a book title. Happy eating, easy on the meat. And be safe.

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  27. Very practical and realistic post. Unfortunately, can relate to some of your experiences and agree with your excellent tips. Very nice photos as usual. Thank you for sharing.

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  28. Great tips and it seems you have learned a lot from experience. Often, we take our health for granted but traveling and experiencing other cultures and foods makes us think about what we eat a little differently

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  29. Some good advice here! Another thing I do is watch what they do when dishes are returned to them. If it’s just dipped in the dirty water before fresh food is placed on it for the next person, I go to another food vendor. At a restaurant the old adage of if they have a clean bathroom, they probably have a clean kitchen is usually spot on, so check out the bathroom before you order food.

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  30. Man does this bring back memories. I got through 2 months in India without so much as a rumbly tummy, only to eat a dodgy pork rind in Chiang Mai, Thailand and spend the next few days pretty uncomfortable.

    Your tips nailed it. I’d add one more though, some wisdom I once got from a looooooong-time globetrotter:

    “Eat where you see mothers taking their kids.”

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  31. @Sasha: Tragically hysterical — just about captures it perfectly. It is hysterical, until you happen to get a piece of that ice in your sugar cane juice 🙂

    @Agne, Roy: Thanks!

    @Jeremy: We’ve gathered a bunch from our experience, some of it hard lessons. As travelers your perspective on health, maintaining it, and what you choose to do in light of it all is a learning module in itself.

    @Talon: Very good point about watching how dishes are washed, and what sort of water, solution, or munge they are washed in. Many places in SE Asia seem to have a final bleach wash these days.

    I wish I could say that we abide by the “clean bathrooms” motto, but alas, we do not. We’ve eaten in 100s of tasty restaurants with absolute horrorshows for bathrooms.

    Looking at kitchens is a good idea, too. However, we abandoned that too when we went to Bangladesh. All we hoped for was that the food was hot when it came out. (It wasn’t always, but we managed to stay healthy anyhow.)

    Thanks a bunch for the thoughtful comment.

    @Anthony: I hear you. Chiang Mai is easy — just the sort of place to ease up and let your guard down.

    Wow, I like that: Eat where you see mothers taking their kids. That works, except in cultures where there are no women out and about…thereby excluding many Muslim cultures.

    Thanks for the comment and tip!

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  32. Totally agree with the Yogurt tip. I have found that it doesn’t matter which country I’ve travelled to, there is always someone selling homemade yogurt in the local market. As bad as it may taste, it keeps the intestines in order. Beat the bacteria at their own game.

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  33. @Diana: Homemade yogurt is fabulous. Am glad that you are able to find it everywhere you travel.

    “As bad as it may taste, it keeps the intestines in order.” — I love that. I’m laughing. It sounds paradoxical, but it’s so true.

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      • Good question, Clare. I did not mean to imply that it’s impossible for yogurt to make you sick. Certainly, any dairy could, depending on how old it is and in which conditions it is stored and served. What I did mean to imply is that properly handled, fresh unpasteurized yogurt has never caused me any problems. Instead, I have found it refreshing and also positive for my digestive health. I hope that helps.

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  34. Ice in India is what got me. I let my guard down after 3 weeks and then I lost everything for four days. It is easy to see why so many people die from dehydration on our planet everyday.
    good article

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  35. @Joe: India and ice…a dangerous combination. Sorry to hear about your experience. Good point — we are just travelers, so we can retreat and recuperate. For others who live there, it may not always be so easy.

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  36. Great post! That is my biggest issue when traveling. I don’t worry about any danger or how crappy the hostel might be… I just hope my stomach will hold up! I got pretty sick in Namibia from eating zebra carpaccio. But at least it was really tasty!
    In Turkey I am not sure what got to me. On Easter Island my stomach killed the last day and a half. I am pretty sure it was from the empanadas.

    What is your thoughts on eating cheese when traveling?

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  37. @Michael: Cheese? The older and furrier it is, the better. Seriously, cheese works for us, but in small doses. Large quantities of cheese are just not good for the digestive system. It’s still safer than meat, in my opinion.

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  38. Great article! Shame you had to write from first hand experience. My worst fear when travelling is getting terribly sick and being stuck on a long haul bus ride… it’s the stuff nightmares are made of! Good to know about yogurt, will make sure I include it in my brekkie whenever I can.

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  39. @Brigid: It comes with the territory, it comes from experience. As for the worst travel health fear, bloated on a bus is up there. If you happen to be on a bus, there’s not a whole lot you can do, except hope that there’s a bathroom on board.

    As for yogurt, we eat and drink it for breakfast, lunch, dinner when the need or mood strikes. There’s no bad time for it. You might even say that yogurt isn’t just for breakfast anymore.

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  40. Great summary. I agree with the chilli sauce observation. I have eaten bread and hot sauce on a number of occassions. Been laughed at, and then had the last laugh the morning after!

    If in doubt about the restrooms add a glass of hot water to your drinks order and use that to rinse your hands. As for street food, make sure its cooked in front of you and piping hot. Theres nothing more likely to upset your stomach than cooked food thats been sitting around.

    Additionally try to choose establishments that “look” popular with locals as they are your best food critic. If there’s no one eating there then it is either closed or to be avoided.

    oh yes, Most importantly. Make sure that bottled water is opened at your table and that you hear the seal being broken. There is nothing worse than tap water masquerading as bottled.

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  41. @Fiona: You are welcome.

    @Nostradamus: I like the suggestion of ordering a glass of hot water. And we totally agree: street food can actually be better because it’s fresh, piping hot and turning over quickly. But the food that’s been standing around, give it a pass.

    The tip of looking for restaurants popular with locals is a good suggestion (and what we do) not only for stomach health, but also for finding good food. And usually good food that’s reasonably priced. Go where the locals go!

    Regarding the water bottle being opened at the table, that’s a healthy dose of skepticism. And a fair point, especially in places like India where resealed bottles are pretty common.

    Thank you for a thorough and useful comment.

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  42. Some scientific proof of spicy killing bacteria.

    I’d also add to the list… don’t eat seafood, especially shellfish, when you’re far from the ocean. 🙂

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  43. @Leigh: Hurrah for scientific proof of what we’ve thought for years! I knew all of those habenero peppers from Mexico were doing some good 🙂 And good advice on seafood far away from the ocean…always cringe when I see sushi places in mountain villages.

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  44. Like the pun at the end (whether intended or not) – “crap shoot”. LOL.
    We are traveling to Cambodia in December to visit our daughter and this will prove very helpful.

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  45. @Pam: Intended. Glad you liked it.

    Enjoy Cambodia. We’re sure you’ll have a great time! Any questions we can help with, let us know.

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    • well I spend a lot of time in Cambodia not yet been ill but I don’t eat too much as I find I can’t trust anyone.I suppose it would be better to eat at home and by your own fresh food.I have a girl friend in Cambodia and sometimes see her family,of cause that means eating with them but for me it’s a horrid exspeariance they eat with fingers and have so dirty nails and spit when they talk nothing is clean and they think I’m a snob. Okey what can I do about it? Give up the girl can’t educate her,may be I should go back to Australia.
      Thanks for reading Richard.

      Reply
      • We’ve been in a few dirty nail shared food situations as you describe. If you must eat, and often custom dictates that you do, you grin and bear it. (And I make certain to use a lot of hot sauce.) Outside of that, if the situation is almost constantly uncomfortable, then I think it’s time to mention the issue and if it does not get addressed to your needs, perhaps it’s time to move on. Good luck and eat well!

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  46. This is an ‘evergreen’ post! We just re-read to remind ourselves of how to survive as we visit the local Bali warungs. Thank you!

    Reply
  47. Thank you for tips. Peru is my home when I’m not in the U.S. Every time I go home I get sick and I’m pretty sick of it! Also, the fruit is wonderfull and so are the vegetables but I’m afraid to eat them fresh. I love the tip about purified water and a little bleach for washing the fruit before peeling and eating. I’d love to lose weight but not by hugging the bowl! I had been thinking to eat all the fruit and vegetables I can fast, knowing I’m going to get sick. I think you might have saved me, maybe.
    Thank you.

    Reply
  48. @Martita: Glad our tips were helpful…even in possibly saving your life 🙂

    Please let us know how it works out next time with the fruits and vegetables, whether you are in Peru or somewhere else.

    Reply
  49. I see yogurt mentioned a good bit. I eat it in the US all the time and with no issues but I’m wondering how I can trust that it will be safe when traveling in the developing world. I see it often in coolers but the skeptical part of me wonders just how long it has been left out before being re-chilled.

    Reply
  50. @Bonnie: We’ve never gotten sick eating yogurt in developing countries, even when it’s been fresh yogurt (e.g., curd in India). But you’re right in that there are no guarantees. Because of the nature of yogurt having bacteria as part of it, I still think it’s a safer bet than meat or uncooked vegetables. That said, if you see that the yogurt is expired and the packaging looks beat up, I’d give it a pass.

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  51. I just returned from a month in India. I didn’t get sick once. I took with me a camelback UV water sterilizer. I sterilized even bottled water as much as I could. I washed my face and hair with this sterilized water. I ate at high end restaurants. I also took along with me small packs of peanuts, almonds and pumpkin seeds and some Boars Head bacon that is pre-cooked and needs no refrigeration. I used alcohol wipes and washed my hands long and often. Also, wipe off any water bottles that have droplets of water on the outside. Have a great trip!

    Reply
  52. Great tips – I concur with them. We certainly agree with you on the high turnover stalls – we were a few years back in Ulcinj in Montenegro, the very definition of ‘the back of beyond’ hard up against the Albanian border, and we sashayed down the high street every night looking for something to eat – something our fellow German tourists regarded with some horror, as they headed for the expensive steak restaurant at the top of the high street, and we the cafe at the bottom, with a plentiful queue of Kosovar, Serbian and Albanian tourists. We were rewarded with (for €2 each) delicious and fresh kebabs – the other Germans with food poisoning, as the restaurant they visited didn’t actually shift that much food.

    Infact, the only time I have ever suffered REALLY badly in 20 years of backpacking was after eating an undercooked McDonalds in Vienna.

    Reply
  53. @Phyllis: Glad to hear you had such a good trip to India without any stomach ailments. We haven’t yet used the camelback UV water sterilizer, but it looks like a great device. We carry a Steripen which has a similar water purification function. Packs of trail mix and nuts are a great snack to bring along.

    @Ric: Turnover is so important, whether at street stalls or at formal restaurants. We’ve heard many stories of people eating at high end restaurants to be on the “safe side” only to get sick there. Thanks for sharing your story!

    Reply
  54. Great advice. I like the high turnover one. I never would have really thought of it but it make a lot of sense. I like you try to eat out of street stalls and from a few years abroad have never got properly sick. I have had to make a few dashes to the toilet though! I also agree that a gentle build up when in a foreign country is a good thing to get you used to the local germs.

    Reply
    • Thanks, Ross. Glad you’ve enjoyed generally favorable digestive health during your travels.

      I think we’ve all had a few of those “dashes to the toilet” you refer to.

      Reply
  55. I think another good rule is to keep up your nutrition. I had an iron stomach eating street food like no other until I got married to my husband. He’s picky and vietnamese. Since it looked healthy (even if lacking variation) it took a major breakdown in health and several street food incidents before a doctor perscribed me major vitamins rather than medicine before I realized how unutritious fish and leafy greens every day were.

    Now that I am eating a varied diet again (he still gets his fish and leafy greens, but not every meal) and the iron stomach and health is back and my body can fight most unwelcome desease itself. So keeping up your nutrition is important to being an adventurous traveling eater.

    Reply
    • Thanks for your comment and contribution, Jenn. Absolutely critical to travel tummy health: nutrition and the variety required to keep it up.

      I’ve also seen recent studies that suggest regular exercise keeps the gut in good bacteria, too.

      Healthy travels!

      Reply
  56. Great article! My mom is also a firm believer in washing and peeling all fruit and veg in a foreign country. But as your post says a little bacteria is not so bad ha! Eating healthy while travelling can be a struggle especially if they are known for their amazing food *cough* Mexico *cough* there are even more articles stating that healthy eating can be expensive which I think is definitely open for debate in the food blogging community.

    Reply
    • Thanks for the compliment and your contribution, Candice. We found Mexico to be OK. We ate a lot on the street in places like Oaxaca, San Cristobal, Merida, and all the little markets in between. Maybe our systems have adjusted, however.

      As for healthy eating having to be expensive, I’m going to respectfully disagree with anyone making that argument. I’ve spoken to plenty of restaurant professionals and the filthy horror shows that they’ve described in some of the more expensive, higher-end kitchens where they worked was enough to convince me. Additionally, I’ve eaten plenty of street food from places that might look suspect to some, but in the end they are keeping their space relatively clean, they are cookings things fresh and thoroughly and experiencing a lot of turnover. I think those are some of the key magic ingredients to safe eating of street food around the world.

      Eat and be well!

      Reply
  57. Great tips here! I generally agree with only eating peeled fruits and veggies. However, I’ve been eating apples daily and tomatoes weekly for the past 8 months in places like India, Sri Lanka, Nepal, Myanmar and haven’t been sick at all! Maybe I’m pushing my luck by writing it down 😉

    I would also add “working out” into the mix as it’s been shown to boost our immune systems!

    Reply
    • Eat right and exercise. Generally sound principles for life, whether you happen to be traveling or even staying at home. When people find out our age, they ask, “How do you do it?” Travel might be a part of it, but healthy living principles related to diet, exercise and movement are definitely at the core.

      Reply
  58. Pragmatic tips but fortunately i am good with food on the road. But i do have guess that whats happens to people who have not “that easy stomach” 🙂

    Reply
  59. My wife and I are retired and travel quite a lot. Your advice is really good and we do everything that you suggested in your blog. We always carry hand sanitizer with us at all times. One tip that I could add is to be sure and clean your hands after handling menus as they are quite dirty. As for washing fruits and vegetables, we use a mixture of vinegar and water at home. Cleanliness is a priority with us.

    You’re also right about organized tours. We went with Smart Tours to India and about a quarter of the people in our group got sick. We always travel with an assortment of medication for emergencies so we shared some of it with them.

    Reply
    • Thanks for sharing your tips and experience, Bill. Excellent advice. Specifically, wash your hands after handling menus. They are filthy. Basically, if you can, wash your hands just before you actually begin to eat.

      Vinegar is a terrific idea, too. And non-toxic, which is a plus.

      Reply
  60. Great tips and totally agree with all of them! The main place we have been particularly careful on our travels was in India last year. Based on a recommendation from a friend we decided to take some probiotic pills (acidophilus) prior to going and whilst we were there and we also avoided meat completely and stuck to veggie only (plus seafood when close to the sea!). Whether we were lucky or not, this seemed to work a treat as neither of us got sick once in the 6 weeks we were there! 🙂 People might think this is a little overcautious but we definitely didn’t feel like we missed out by doing this as there are soooo many amazing veggie options in India – we absolutely LOVED the food and tried lots of different dishes. Masala Dosa was a favourite! 🙂

    Reply
  61. I too in 2012 went on a trip to India and ate everything in site.
    even though I was informed and educated myself on what and what not to eat or drink,
    my adventuristic side of threw caution to the wind. Boy did I pay for it later. I got very sick. Now im planning to spend 4 nights in Morocco and am planning my strategy.
    I have come to realize that I am very sensitive and my stomach is not nearly as adventurous though.
    what to do? what to do?

    Reply
    • Jeannette, we know how hard it is to resist all the incredibly delicious looking food and juices in India 🙂 For your upcoming trip to Morocco I’d suggest being disciplined with some of the advice above, especially 1) wash your hands often; 2) only eat cooked foods or pealed vegetables/fruits 3) and go to places with high turnover of food (e.g., popular with locals) where food is cooked fresh to order.

      Enjoy your trip!

      Reply
  62. Great tips guys! Its always on the mind when eating at food stalls but you just can’t deny that street food is some of the best food ever! lol!
    there are some tips here we follow and new ones we will follow form now on, thanks for the tips.

    Reply
  63. In my first 6 months in Mexico I was getting a bad case of the runs about every two months. Which I felt was a tad on the excessive side, and while I wasn’t as careful about what I ate as others I generally followed the rules. Of course I was a young bachelor in my twenties at the time. My guess is your average middle-ager would keep a much cleaner kitchen than I did.

    My buddy Tom made sure he had a shot of tequila, ate some salsa and a couple of limes every day. He claimed that was why he never got sick. I told him he was full of it, but after 6 months, out of desperation, I gave it a try. Everything was a hell of a lot better after that. From then one I would get the runs for a day or so about every 8 months, and didn’t have anything truly horrifically explosive again.

    Reply
    • Thanks for the comment and story, Kevin. Glad to see you here.

      There’s definitely something to the idea of alcohol, hot peppers and the acidity of citrus in terms of their preventive or prophylactic effect. Totally agree. Having said that, my recommendation for young or old is that if you think your own kitchen hygiene is the culprit, it’s time to clean up. I once ate from a batch of tasty mango salsa in Mazunte that was made in the sketchiest kitchen. The killer, though, was the sketchy water the vegetables were cleaned in. Can do it every time.

      Reply
  64. This is just a quick thing to add – when I went travelling, I took toilet seat covers, a pack of 10, just to be on the safe side if you 100% had to use dirty facilities. Even if you’re stomach is fine, they’re good to have on you as you never know. I kept them in my backpack all the time and didn’t have to think about it too much!

    Reply
    • Thanks for the addition, Fran. Unfortunately, some of the worst toilets and facilities I’ve encountered seem beyond the help of seat covers. The phrase “air gap” comes to mind. Healthy and safe travels!

      Reply
  65. Hi Daniel,
    Thanks for the amazing post. i was addicted to eating at Jamaa Elfna Square in Marrakech until i got married. My wife’s stomach could not tolerate street food up there. Every now and then, we go there together, i eat a sheep head while she watches me disgustingly!!

    Reply
    • I think, perhaps unknowingly sometimes, that I’ve dined on my share of sheep’s head. What I’m more concerned about than anything when it comes to how my stomach will handle it is the cleanliness of the food preparation and serving of it. I trust there’s high food turnover in the market there, though.

      Reply
  66. I know you guys wrote this years ago but I just had to comment on the title of the post because it made me LOL.

    One to add: When I worked on the Semester at Sea ship for half a year, our ship doctor taught all of us to take two Pepto Bismol tablets before every meal (particularly when we were in Ghana, India, Vietnam, etc.). He said it reduces the risk of food-borne illness by 80%. Lo and behold, I’ve taken that to heart and hardly ever gotten stomach sick in my travels since then!

    Reply
    • Pepto bismol as a pre-meal prophylactic, who knew? I suppose bismuth, the active ingredient in there, probably has some anti-bacterial properties. I still prefer hot sauce, though 🙂

      Glad to hear the title had the desired effect. I related to a friend one of the stories from this piece recently. As I did, it reconfirmed that bowl-hugging remains the apt visual.

      Thanks, Kristin!

      Reply
  67. Very good tips on staying healthy while traveling. I learned this the hard way when going to Thailand a few years ago. Stayed away from the water but ice too can get you sick especially since it often melts into the drink and is made from tap water in most cases.

    Reply
  68. I really like your tip about making sure that you peel your fruits and vegetables when it comes to eating when you are traveling. My husband and I are going to be doing some traveling in the next few months and we want to find some really great restaurants to eat at. We will be sure to keep these tips in mind, thanks for sharing!

    Reply
    • Glad you found our suggestions useful, Danni. Since we just returned from another visit to Kyrgyzstan, it occurs to me that the “peel your fruit” suggestion really depends on where you are traveling. In Kyrgyzstan, we ate plenty of unpeeled apples, since we believed doing so to be safe. We are glad we did. Safe and healthy travels.

      Reply

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