sidered safe. However, when in doubt, remem-
ber 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 poten-
tially 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 subsali-
cylate. 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
when choosing food and beverages. Certain pro-
biotic organisms, such as lactobacillus GG, have
been shown to be effective in stimulating anti-
body production against rotavirus (Kaila et al.
1992, 1995), and to reduce the duration of diar-
rhoea (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 recom-
mended for the treatment of childhood diar-
rhoea, 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 formula-
tion 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 perfor-
mance and may even prevent an athlete from
competing. Adequate sleep and rest, mainte-
nance 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’sthe travelling athlete 489
Table 36.1Foods and beverages generally considered
to be safe or potentially unsafe.
Safe Unsafe
Steaming hot food Moist foods at room
Dry food (e.g. breads) temperature (e.g.
High sugar-content sauces, salads and
foods (e.g. jellies and buffet dishes)
syrups) Raw or undercooked
Fruit which can be meats, fish and
peeled (e.g. bananas, shellfish
oranges and melons) Unpeelable raw
Bottled drinks in their vegetables and
original containers (e.g. fruit (e.g. grapes
carbonated water, soda and berries)
and sports drinks) All dairy products
Coffee and tea, if Tap water
steaming hot Ice cubes