These days the word gluten-free is everywhere, from the grocery store aisles to restaurant menus to morning talk shows. The growing prevalence of people suffering from gluten-related disorders has even spurred a group of 15 experts to propose a new classification system for such conditions, as recently reported by the Wall Street Journal.

Gluten wreaks the most havoc in celiac disease, when the gluten protein triggers an immune attack against the intestine. Milder sensitivities to gluten can still cause miserable bloating and bowel problems. Gluten is in a lot of foods, so maintaining a gluten-free diet can be a daily challenge - especially when you’re traveling and it seems like sandwiches, pizza and flour tortilla wraps are the only foods available.

With a little preparation, though, eating gluten free on the road can be made painless. The first, and obvious, solution is to bring your own gluten-free snacks. That way, you’ll never be starving when you decide on your meals and you can ensure no cross-contamination. Here are some additional tips and resources for long-haul trips or when there’s no extra room in your carry-on for gluten-free snacks:

• Request gluten-free meals inflight. You’ll need to request these meals ahead of time, so make sure to do so when you book the flight. Browse the forums on FlyerTalk for reviews of the special food served on various airlines. You can even see photos using AirlineMeals and its handy drop-down search function.
• Know what to expect from international food labeling. In most of Europe, foods are labeled “gluten-free” if they contain less than 20 parts per million of gluten when independently tested. Less-developed regions will be less likely to offer this, and you’ll be better off sticking to fruits, vegetables and meats cooked simply, without complicated sauces.
• Carry a list of gluten-containing products, such as this one in your pocket or purse. Note that some things are less-obvious offenders, like teriyaki sauce.
• Research the foods common to the place you’re visiting. For example, bulgur wheat is a staple in Mediterranean food, and you’ll have an easier time if you know what it looks like and the dishes it’s featured in, such as the ubiquitous tabbouleh salad.
• Don’t be shy about making special requests in restaurants. Ask that a few of the ingredients you see on the menu be combined into a special salad. If the menu items listed contain gluten from croutons or other ingredients ask they be left off. Chefs should be happy to oblige.

Monya De, ’00, MD, MPH, manages social media for MD Delivered, Inc. of Los Angeles and Orange County. She received her BA from Stanford in human biology.

Previously:Guest post: Healthy traveling is happy traveling, Guest post: “Am I contagious?” and A call for a new way to classify gluten-related disorders
Photo by Antonio Viva

“Am I contagious?” Doctors hear this question all the time. Patients want to know if they can go back to work or school. Parents wonder if going to a birthday party will mean inflicting pink eye on 30 kids. Airlines are concerned their flight attendants could be handing out gastroenteritis with the ginger ale.

When people keep their buggy selves quarantined, other people benefit. The problem is, it’s often hard to keep track of how long different viruses or bacteria can be transmitted to others. According to the National Institute of Allergy and Infectious Diseases, the likely reason that wintertime brings on more coughs and colds is that we are spending more time indoors at work and school - putting ourselves within reach of viruses hanging out on other people.

Armed with a little knowledge, you can minimize the transmission of your germs or your kids’ to other people. Here’s a list of common contagious diseases:

• Conjunctivitis (pinkeye) is a notorious kid-hopper, and long-enduring too. Plan on about 10 days until the eyes are no longer red - your signal that the virus is done.

• Colds are common for a reason: cold viruses are hardy enough to keep infecting 5 days after you get sick (10 days for children). Remember, too, that cold viruses hang out on inanimate objects (doorknobs, computer mice) for several hours, so you may want to chase your sick child’s path around the home with some disinfectant.

• The dreaded strep throat is luckily a complete wimp against the most simple of antibiotics, but you should quarantine for 24 hours after the first dose if your doctor says it’s definitely strep.

• I hope you’ve already been vaccinated against whooping cough (especially since the vaccine wears off in adulthood and needs a booster), but for those unlucky souls who get it, assume 2-3 weeks of contagiousness. And, considering how scary this cough sounds, you might want to hide in your house anyway.

• Influenza (real flu, with fevers and serious muscle pain) is a significant cause of mortality in the elderly and young. Do us all a favor, and stay at home until there has been no fever for 24 hours.

• Sexually-transmitted diseases (in this case, chlamydia and gonorrhea) mean no sexual activity until antibiotics are completely finished, and there are no more symptoms.

• Chickenpox shows you that it’s done infecting. If the spots are crusted over, you’re good to go. This is true for shingles also. Note that shingles can cause chickenpox in people who haven’t had it before. So avoid schools and babies if you’re an adult with shingles. If you are going back to work before the crusting happens, make sure that everyone in your office has already had chickenpox first.

While I hope you find this information useful in making sure you don’t infect unsuspecting others (and perhaps knowing how long to avoid that coughing woman in sales), it’s not meant to replace the evaluation and determination of your doctor, who will address your specific medical needs and can make a diagnosis and give you the appropriate care.

Monya De, ’00, MD, MPH, manages social media for MD Delivered, Inc. of Los Angeles and Orange County. She received her BA from Stanford in human biology.

Previously: Guest post: Healthy traveling is happy traveling
Photo by eyesogreen

Wintertime means the joyous anticipation of time off school or work, and trips near and far to visit relatives or bask in the Hawaii sunshine. Unfortunately, winter vacation can also bring colds, strep throat or food poisoning. Here are three tips to have a terrific time while avoiding trips to urgent care:

Practice scrupulous hygiene, and teach your kids the same.

I can’t over-emphasize the importance of this. If you’re casual about hand-washing, now is the time to step it up. Open public restroom doors with a tissue. Use your knuckles to push elevator buttons in the hotel. Carry your own pens. Wipe off hotel phones before using them. Remember, if someone can cough on it or touch it after using the restroom - well, you know the rest.

Get plenty of rest.

We can hear all the harassed mothers laughing bitterly at this one as they pack feverishly for Grandma’s, but being exhausted is like holding up a huge WELCOME sign for viruses. Immune systems work pretty well when they aren’t taxed to the limit. How many times have you “powered through” the work week, made it on to the plane, and woken up sick at your destination the next day? Consider taking a half day off work extra to prepare, or plan to have your work duties lessened in the days leading up to vacation.

Be careful about toting food.

With the arduous process of getting multiple people packed and ready to go two hours before a flight, that container of yogurt or that turkey sandwich might not have seen a refrigerator for a good while before you finally end up eating it. Keeping things frozen until you tote is a good strategy; you can also invest in some insulated containers to keep food cold.

Monya De, ’00, MD, MPH, manages social media for MD Delivered, Inc. of Los Angeles and Orange County. She received her BA from Stanford in human biology.

Previously: Avoiding illness during air travel and Stanford nutritionist offers guidelines for eating healthy on the go
Photo by lunchtimemama