The Travelling Athlete

Chapter 36
The Travelling Athlete
ANN C. GRANDJEAN AND JAIME S. RUUD
Introduction
Spectators perceive the life of the international
athlete as glamorous and exciting, but the travel
involved in training and competition can have a
devastating effect on performance. Many professional and elite athletes travel long distances on a
regular basis to train and compete. Top American
basketball players are away from home for a
large part of the year, and travel is so much part
of the routine that it has become a way of life. In
many sports, travel must be accommodated in a
rigorous training and competition schedule: jet
lag and travel fatigue are not accepted as excuses
when there is a high expectation of success. A
good example is the US Women’s Olympic basketball team, who travelled more than 161 000
km in 14 months prior to the games to promote
women’s basketball and to win the gold medal in
Atlanta (Wolff 1996).
Whether flying for 12 h or longer to another
continent or jumping on a bus to compete in a
neighbouring town, travel can cause a major
disruption to an athlete’s training programme.
Major events may require extended periods of
travel: the Sydney Olympics, for example, will
require competitors from Europe to travel for
at least 24 h to reach their accommodation or
pre-Games holding camps. Successful athletes
should have an established training programme
that includes a workout schedule, proper nutrition, adequate sleep and stress management,
although in reality this is often not the case.
When something happens to interfere with this
484
schedule, the break in routine can be physiologically and psychologically damaging. Diet is one
of the major factors that may lead to disruption of
an athlete’s training programme away from
home. Food intake often depends on local restaurant facilities, concession stands, or vendors,
which means access to familiar foods may be
limited. Consumption of unfamiliar foods and
beverages, especially in large amounts, can result
in severe gastrointestinal symptoms: even minor
discomfort from gas, diarrhoea, or constipation
may be enough to adversely affect performance.
Potentially more serious, and even fatal, illness
contracted from eating contaminated foodstuffs
is as great a risk for the athlete as it is for all international travellers. Even where familiar foods
are available, interrupting the athlete’s normal
eating and training schedule can negatively
affect performance.
There seems to have been no serious attempt to
quantify the effect of eating disturbances resulting from travel on sports performance, and there
is little published information in this area. Much
of the information in this chapter is based on the
authors’ professional experience and on experiences reported by athletes, coaches and team
physicians. Inevitably, most of these reports are
anecdotal, and even individual case reports are
seldom available. To broaden the range of experiences, we surveyed sports nutritionists from
each of the continents to glean information from
their experiences and to provide the reader with
practical suggestions. Interestingly, two problems were reported by all respondents: food
the travelling athlete
availability and food safety. Jet-lag, risk of dehydration, body mass changes and food allergies
were also identified as challenges for the travelling athlete.
Food availability
Without hesitation, athletes, coaches, trainers
and sports nutritionists list ‘not having the food
we need available’ as the number one nutritional
problem when travelling to a training camp
or competition. While this can be a hurdle for
all athletes, it is particularly difficult for those
whose nutritional plan involves frequent small
meals throughout the day: some athletes, especially those engaged in hard training, eat seven
to eight meals or snacks each day. Local and
regional events present fewer problems, as athletes can bring their own food, either on an individual or team basis, or can ensure that local
restaurants or hotels have the appropriate food
available. However, the greater the distance to be
travelled and the longer the time to be spent
away from home, the more important it is to plan
well in advance if athletes are to be able to follow
their nutritional plan. On long trips or training
camps, it is not possible to be self-sufficient. One
problem in such situations is the short menu
cycle in many training camps: restaurant or hotel
dining may be even worse, with no change of
menu. A menu or self-service buffet that appears
varied for the first day can become extremely
monotonous after only a few days.
For high-altitude training, Finnish athletes
train in countries such as Switzerland or Austria
and often stay in small villages: the accommodation is usually in private hotels run by families
where the food is plentiful but not always the
high-carbohydrate foods that many athletes
prefer, and again with little variety. At these locations, travel to training venues is usually by bus,
and low-carbohydrate, high-fat foods purchased
at fuel stations may be the only food available.
Similar situations are reported from athletes in
many other countries. Here, as in all situations,
athletes require some nutritional knowledge to
allow them to make the best food choices. Some-
485
times special arrangements can be made with
hotel owners to ensure a menu that will meet the
athletes’ needs, and to provide meals that can be
taken to the training venue, but such arrangements may not be possible. Many athletes use
sports drinks and high-carbohydrate snacks to
maintain carbohydrate intake, but this can lead
to an unbalanced diet: while this may not be
important in the short term, athletes may spend
weeks or even months at some training camps.
Chinese athletes, when travelling in the West,
prefer to bring their own foods such as noodles,
canned porridge, salted vegetables (such as hot
pickled mustard tuber) and chocolate. While
there is no single solution to all travel problems,
as all athletes, coaches, team physicians and
nutritionists know, planning ahead is essential if
the athletes’ needs are to be met.
Athletes or teams preferring to take food for
the trip need to consider not only the perishability of food, but also airline restrictions on the
weight and number of pieces of luggage. A US
boxing team travelling abroad for a month of
training and competition augmented their diet
by taking canned tuna, peanut butter, crackers
and chocolate bars. These items provided a significant amount of energy and nutrients while
not adding significantly to the weight of the
luggage. International travel is likely to impose
limitations on the type of foods that can be taken.
Many countries, including the US, have customs
laws that prohibit the importation of fresh fruit,
vegetables and meat products: such restrictions almost invariably apply to intercontinental
travel. The penalties for contravening import
regulations may be severe, apart from the confiscation of the team’s food supply, and all team
members must be aware of the restrictions that
apply. Advance planning should prevent this situation from arising.
Some travelling athletes choose to take only
enough food to serve as a backup, and expect to
rely on local food sources for the majority of their
needs. Common ‘travel food’ for US athletes
include dried pasta, canned or powered sauces,
cookies, canned meat and fish, peanut butter,
soups, nuts, chocolate bars, crackers and sports
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practical issues
bars. Other athletes travel with sufficient food to
meet all of their needs and with cooking equipment which makes it possible to prepare food
under a variety of travel and living conditions.
Electrical current and plug adapters are an essential, but sometimes forgotten, part of this equipment. Distributing supplies and equipment
throughout the baggage will help to ensure that
it will reach the desired destination, and reduce
the possibility of the entire supply being lost.
Body mass changes
Another common concern related to travel and
diet is body mass (weight) change. Athletes
report that prevention of unwanted body mass
loss or gain may be a major challenge while travelling. Body mass loss is likely to occur if athletes
do not have access to an adequate supply of
appropriate food and beverages, but it may also
occur in the midst of dietary abundance. It is
not uncommon, especially for athletes travelling
abroad for the first time, for local foods to be
avoided, perhaps because of a dislike of the unfamiliar, an uncertainty over the content or a fear of
an adverse reaction. This is likely to lead to a
reduction in energy intake and a loss of body
mass. Athletes experienced at travelling will
usually learn to eat in spite of taste preference or
will ensure their own supply of food because
they recognize that an inadequate intake leads
to less than optimal performance. Even for
the experienced traveller, however, some disruption is likely until a new routine is established.
This involves identifying the location of dining
facilities, restaurants, etc., as well as recovering for the effects of jet lag and travel fatigue,
and it is during this period that a supply of
snacks brought from home may be particularly
valuable.
On the other hand, there are times when the
local cuisine is so appetizing, that the athlete will
overeat. This is typical in a dining hall setting
where there is a variety of food choices and
portion sizes are generous or where there is a
self-service facility. Boredom, increased eating
opportunities and the provision of food free of
charge in a training camp are also factors that
will lead some athletes to eat more than they
would at home. This may be particularly the case
at major championship events: the dining facilities at the Olympic Village, for example,
provide a wide range of high-quality food free of
charge 24 h · day–1. For the athlete in a weight-category event whose first competition is not until
near the end of the programme, 2 or 3 weeks
spent in the Village, with a reduced training load
and little to occupy the time, provides a severe
challenge to self-restraint. This is a particular
challenge for athletes from countries or from
social backgrounds where such food is seldom
available.
In both of these extreme situations, there may
be advantages in regular monitoring of body
mass as a guide to the adequacy of the dietary
intake. This is not, however, as straightforward
as might at first appear. A fall in body mass may
be the result of an inadequate energy intake, but
may also reflect some degree of hypohydration,
particularly in warm weather. Athletes may
experience some loss of body mass during a
training camp if the training load is increased
above the normal level, and this may be desirable
or not, depending on whether there is a need for
the athlete to reduce the body fat content and
whether the mass loss does indeed reflect a loss
of body fat. Ekblom and Bergh (Chapter 51) have
reported that the daily energy requirement of
elite cross-country skiers during normal training
is about 20–25 MJ (4780–5970 kcal) and that this
may increase by 4–8 MJ (950–1910 kcal) during
training camps. An increased body mass may
indicate overeating, but is also a normal response
to a reduced training load in the days prior to
competition. Changes in the diet may induce
constipation, leading to a small increase in body
mass.
Dehydration
Travel increases the athlete’s risk of dehydration.
An adequate intake of fluids is essential, especially on long-range flights as the low water
vapour pressure in aircraft cabins leads to an
the travelling athlete
487
an adequate amount being available and each
athlete should be self-sufficient for the duration
of the flight. Particularly when travelling to hot
climates, sufficient fluid should be taken to allow
for delays at immigration and customs upon
arrival.
Jet lag
Fig. 36.1 In many sports, elite performers travel long
distances on a regular basis. This adds many problems
when there is little time for recovery between
competitions. Photo © Allsport / A. Bello.
increased loss of water from the respiratory tract
and through skin. Drinking fluids before, during
and after travel is essential. Carrying bottled
water can provide fluid, while sport drinks, juice
packs and soft drinks provide both carbohydrate
and fluid. On transcontinental flights, most airlines are aware of the risks of dehydration and
frequently offer water, juice or soft drinks. If this
service is not sufficient, ring the flight attendant
call button and request fluids on a routine (e.g.
hourly) basis. Ask for a whole bottle or can, or
even two, rather than a small glass. When a large
team is travelling together, the airline might
be warned in advance that demand for fluids
is likely to be high and an extra provision
requested. In any case, it is unwise to rely on
Jet lag is a common problem for athletes who
travel through different time zones (Reilly et al.
1997a). It results from a disruption of the body’s
rhythms and sleep–wake cycle. Fatigue, disturbances of sleeping patterns, poor concentration,
digestive problems and irritability are usual
symptoms of jet lag. Studies have shown that the
‘competitive edge’ can be lost after crossing as
few as one or two time zones (US Olympic Committee 1988). Symptoms of jet lag are generally
more severe when travelling from west to east
rather than in the opposite direction (Reilly et al.
1997b). Although athletes generally suffer less
than sedentary individuals, in terms of general
symptoms (Reilly et al. 1997a), the implications
for performance are perhaps more serious for
the athlete who may have to recover quickly
and compete soon after arrival. A rough rule of
thumb is that one day is required at the new
destination for each time zone crossed, but it is
clear that there is a large variability between
individuals in the speed of adjustment.
Both the type of food consumed and timing of
meals are important considerations in helping
the body adapt to time zone shifts. Although the
light–dark cycle is perhaps the most important
signal involved in setting the body’s internal
clock, the timing of meals and of exercise are also
important signals. The composition of meals and
the amount of food eaten may also have some
impact. High-protein foods (meats, cheese, fish,
poultry and tofu) are reported to stimulate the
adrenaline pathway and increase alertness.
High-carbohydrate foods (pasta, rice, bread,
fruit) increase insulin secretion, which facilitates
the uptake of tryptophan, an essential amino
acid which is then converted to serotonin, and
ingestion of meals with a high carbohydrate
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practical issues
content may be followed by a feeling of drowsiness. Thus, what and when an athlete eats may
influence the severity and duration of jet-lag
symptoms, and it has been suggested that highprotein foods should be eaten at breakfast time
and high-carbohydrate meals taken at night
(Reilly et al. 1997b). Central nervous system
stimulants, such as the caffeine in tea and coffee,
may be beneficial when taken in the mornings
on arrival at the new destination, but are best
avoided in the later part of the day. Drinking an
adequate amount of fluids is also recommended,
as dehydration can aggravate the symptoms of
fatigue and jet lag. This implies a need for care in
the use of caffeine-containing beverages and
alcohol because of the possible diuretic effects.
Where a single major event involving longdistance travel is scheduled, there may be advantages for some individuals in preparing before
departure. If this is to be attempted, it might be
suggested that, 3 days before travel, athletes
should begin training, sleeping, eating and
drinking according to the time of their destination. It should be recognized, however, that
attempts at preadjustment by changes in lifestyle
have generally been found to be ineffective
because of the difficulty in controlling all the
factors involved.
In recent years, melatonin has been used by
some athletes to avoid jet lag (Grafius 1996).
Melatonin is a hormone derived from the pineal
gland that affects the body’s sleep–wake cycle.
Research has shown that low doses of melatonin
taken in the evening can help induce sleep
(Zhdanova et al. 1995). Oral doses of melatonin
(0.5–3 mg) taken 1 h before bedtime appears to be
safe and effective (Grafius 1996). However, as
with any substance, melatonin may be tolerated
differently by each athlete. Morning grogginess
and vivid dreams have been reported with use
of melatonin. For the athlete who wants to try
melatonin, experimenting with it prior to travel
or competition is recommended. Melatonin is
not included on the list of prohibited substances.
The purity of commercial preparations is uncertain, and melatonin content of some preparations
may be less than the stated dose.
Traveller’s diarrhoea and
other infections
Once an athlete arrives in a new country, one of
the greatest fears is becoming ill just prior to
or during competition. Although there is little
recent information, one report suggests that
up to 60% of athletes travelling abroad may be
affected by some form of gastroenteritis
(Grantham 1983). Food-borne illnesses and
gastrointestinal distresses of other aetiology can
prohibit participation or diminish performance.
Traveller’s diarrhoea is a concern to athletes irrespective of the country of origin or destination.
Traveller’s diarrhoea can be caused by food or
water that contains bacteria, viruses or parasites.
It is estimated that bacterial enteropathogens
cause at least 80% of traveller’s diarrhoea with
Escherichia coli and Shigella being the two most
common agents (DuPont & Ericsson 1993).
Clinical features of traveller’s diarrhoea include
frequent loose stools and abdominal cramps,
sometimes accompanied by nausea, vomiting or
the passage of bloody stools. Since contaminated
food and water can cause traveller’s diarrhoea,
athletes need to be cautious of what they eat
and drink and to apply stringent food hygiene
rules. Prevention of the problem involves
selecting eating establishments that are well
known or recommended by coaches or other
individuals who have been to the area before and
who are aware of the food safety issues. Contacting your country’s embassy in the country of
your destination to identify in advance potential
problems can also be of value. Information on
immunization requirements and recommended
prophylactic precautions should also be established well in advance of travel, and this advice is
readily available from travel agents, airlines and
embassies.
Foods such as fruits that can be peeled and
vegetables that have been thoroughly washed
with boiling water are generally safe food
choices. For the most part, athletes should drink
only bottled water, juices or soft drinks from
sealed containers. The following list provides
guidance for foods and beverages generally con-
the travelling athlete
sidered safe. However, when in doubt, remember the phrase, ‘Boil it, cook it, peel it or forget it’
(Mayo Clinic Health Letter 1997).
Table 36.1 lists foods and beverages generally
considered to be safe and those which are potentially dangerous.
Foods and beverages are not the only source
of pathogens. If the level of water purity is
unknown, athletes should use bottled water to
brush their teeth and should not swallow water
when bathing. Athletes participating in water
sports, such as rowing or canoeing, need to avoid
swallowing lake or river water.
Oral prophylactic drugs that have been used to
prevent traveller’s diarrhoea in adults include
doxycycline, trimethoprim-sulfamethoxazole,
norfloxacin, ciprofloxacin and bismuth subsalicylate. These drugs are generally taken on the
first day of arrival and continued for one or two
days after departure (DuPont & Ericsson 1993).
However, the disadvantages of prophylaxis
may outweigh the benefits. When used for an
extended period of time, potential side-effects
can occur, depending on the oral agent selected,
such as blackening of the tongue and faeces, skin
rashes and reactions to the sun. Prophylactic
drugs may also give a false sense of security to an
athlete who would otherwise exercise caution
Table 36.1 Foods and beverages generally considered
to be safe or potentially unsafe.
Safe
Unsafe
Steaming hot food
Dry food (e.g. breads)
High sugar-content
foods (e.g. jellies and
syrups)
Fruit which can be
peeled (e.g. bananas,
oranges and melons)
Bottled drinks in their
original containers (e.g.
carbonated water, soda
and sports drinks)
Coffee and tea, if
steaming hot
Moist foods at room
temperature (e.g.
sauces, salads and
buffet dishes)
Raw or undercooked
meats, fish and
shellfish
Unpeelable raw
vegetables and
fruit (e.g. grapes
and berries)
All dairy products
Tap water
Ice cubes
489
when choosing food and beverages. Certain probiotic organisms, such as lactobacillus GG, have
been shown to be effective in stimulating antibody production against rotavirus (Kaila et al.
1992, 1995), and to reduce the duration of diarrhoea (Isolauri et al. 1991). It would, however, be
unwise to rely on these.
If diarrhoea develops, the athlete should seek
medical attention as soon as possible. Because
dehydration is likely to result, it is important to
consume plenty of fluids: bottled beverages,
broth, soup and tea made from bottled water.
Sports drinks, which have a composition similar
to that of oral rehydration solutions recommended for the treatment of childhood diarrhoea, are an effective remedy in this situation
(Maughan 1994). If diarrhoea is a possible
outcome, a supply of one of the commercially
available oral rehydration solutions must be
available: this may not be easily available locally
and should be brought from home. These drinks
contain higher electrolyte levels than sports
drinks and will help maintain fluid balance and
speed recovery: if a powdered or tablet formulation is used, bottled water must be used in the
preparation. If a large fluid loss is incurred and
the athlete has difficulty in taking oral fluids,
intravenous rehydration may be warranted.
A variety of other medical problems, including
upper respiratory infection, abscessed tooth and
general infections, are known to impair performance and may even prevent an athlete from
competing. Adequate sleep and rest, maintenance of hydration status and a nutritionally
adequate diet can help ward off infections. A
daily multiple vitamin/mineral supplement can
also help ensure adequate vitamin and mineral
intakes. In addition, the importance of frequent
and careful hand washing with soap cannot be
overemphasized.
Food allergies and food intolerance
The athlete with food allergies has an additional
challenge when travelling. A food allergy is any
adverse reaction to an otherwise harmless food
or food component that involves the body’s
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practical issues
immune system. A food allergen is the part of the
food that stimulates the immune system of a
food-allergic individual and a single food can
contain multiple food allergens. Proteins in foods
are most commonly the cause of an allergic
response. It is estimated that less than 2% of the
population has a true allergy to food.
Travel guides and books for people with allergies are available. Foreign sources of information
have been published by the Food Allergy
Network and the Information Centre for Food
Hypersensitivity (LIVO). Translation of commonly used allergy terms, food labelling laws,
emergency medical services, travel tips and a list
of non-profit organizations working with food
allergies can be obtained.*
A food intolerance is different from a food
allergy: it occurs when people react adversely
to food but without the involvement of the
immune system. Food intolerances can occur for
a number of reasons. The most common of
these involve enzyme deficiencies, such as
lactose intolerance, which results from a lactase
deficiency.
Developing an eating strategy
It is important that the nutritional needs of the
travelling athlete are not left to chance. A clearly
identified strategy is an essential part of the
preparation process. For team sports, there
should be an overall team plan, but an individualized programme should also be developed for
each team member to take account of individual
needs and preferences. The key elements of the
strategy are as follows.
Recommendations for a nutritional survival
plan include:
• think through your nutritional needs;
* These can be obtained from: The Food Allergy
Network, 10400 Eaton Place, Fairfax, VA 22030–220,
USA; Tel.: 703-691-3179; Fax: 703-691-2713; or The
Information Centre for Food Hypersensitivity (LIVO),
PO Box 84185, 2508 AD, The Hague, The Netherlands;
Tel.: 703510893; Fax: 703547343.
• have a plan and a back-up plan;
• contact hotels and restaurants at your travel
destination and make appropriate arrangements;
• be assertive in making plans and when ordering in restaurants;
• before flights, order special airplane meals if
necessary;
• request extra potatotes, bread, rice, pasta or
other carbohydrate-rich foods;
• take food and drink with you.
Food appropriate for short trips includes:
• breads, biscuits, bagels;
• muffins, cookies, pretzels;
• canned vegetables;
• bottled, canned or boxed fruit juices;
• canned fruit, dried fruits;
• bottled water;
• sports drinks;
• canned meal replacement;
• nuts, trail mix.
Where there are special nutritional requirements, particular care in planning ahead is necessary. Favourite foods or drinks that are used in
training or that make up the pregame meal may
not be available. Vegetarian athletes may experience difficulty in some countries where their
needs may not be catered for.
Conclusion
Athletes are often expected to produce their best
performance in unfamiliar surroundings far
from home. Long-distance travel brings with it a
multitude of challenges and opportunities. In
ideal situations, a member of the sports staff
assumes responsibility for travel arrangements,
visa requirements, accommodation, equipment,
money, itinerary and nutritional needs. It is
important, however, that nutritional issues are
not left to chance. While veteran travellers most
often think of nutrition, the novice traveller may
be more likely to forget. A clear eating strategy,
well rehearsed in minor competitions closer to
home, should be developed. The input of appropriately qualified and experienced staff to the
development of this strategy is essential.
the travelling athlete
Acknowledgements
The authors would like to thank Drs Louis Burke,
JiDi Chen, Mikael Fogelholm, Michael Hamm,
Jon Vanderhoof, Robert Voy and Ron Maughan
for content contributions and Dr Kathy Kolasa
for valuable editorial assistance.
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