Staying Healthy When You Fly

Timothy B. McCall, M.D.

Airplane crashes get lots of media coverage. But air disasters are rare enough and unpredictable enough that short of not flying, there’s not too much we can do to reduce our risk of dying in a crash. But there’s a great deal we can do to reduce other risks associated with airline travel. Here’s what I recommend:

• Keep yourself well-hydrated. Doctors now suspect that everything from jet lag to heart attacks to potentially fatal blood clots may be related to dehydration. The air on the average airliner is as dry as the desert hastening the rate at which our bodies lose water via breathing. And when the mucous membranes lining the mouth and nose dry out, we become more susceptible to any viruses that may be circulating in the plane’s ventilation system. You're best bet is to drink 8-16 ounces of water (or another noncaffeinated beverage) in the hour before you fly—plus a similar amount every few hours aloft.
• Keep moving. Along with dehydration, extended sedentary periods promote the formation of blood clots in the extremities. You can reduce your risk by getting up for a walk every hour or so when you fly. I've found that it's easier to do this if you choose an aisle seat. In addition to taking frequent strolls, I make it a point to wriggle my toes, flex my ankles and shift my seating position. It’s probably also a good idea to gently massage your calf and thigh muscles every hour or so.
• Skip the booze. Many airline passengers like to drink—in part to curb their anxiety about flying. Unfortunately, alcohol acts as a diuretic, increasing dehydration. And in the unlikely event of an emergency evacuation, duller thinking and slower reaction time could spell the difference between getting the plane safely—and being trapped aboard. A better way to relax is to sit up straight, close your eyes and take slow, deep breaths through your nose.
• Consider your food options. Airline food is notoriously unpalatable. And a recent study suggests that it tends to be extremely high in fat. Whenever I fly, I request a special vegetarian meal in advance. The meals are not always great, but they do seem a bit more appetizing—and more healthful—than what the flight attendant brings my seatmates. Just in case, I always bring along a bag lunch—typically a sandwich, yogurt and some fruit--and a bottle of water.
• If you’re sick, consult you’re doctor before flying. Anyone who’s pregnant or has a chronic illness like cancer, heart or lung disease should discuss with their doctor the advisability of flying and any special steps they should take. Even a bad cold could make the changes in altitude painful and risky. Over-the-counter decongestants like pseudoephedrine (Sudafed) or nasal sprays can be helpful. But if you’re severely congested, it may be better to postpone your trip.
• Take steps to avoid jet lag. Though some people use sleeping pills or melatonin, I favor one of the most effective, and safest, jet lag remedies-- light. Try to get out for a walk in the daylight each day after you arrive. Getting enough sleep before leaving and, once you arrive, eating meals on the new time zone's schedule also helps.

My final piece of advice is to arrive early to the airport. That way, you can relax—maybe get a little reading done--while most of the people around you are scurrying frantically to their gates. No sense adding any extra stress onto what most of us find stressful enough.

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