Tag Archives: Health

Airline Food Survey 2020

The following is a study of 11 major airlines’ snack and on-board food offerings conducted by Dr. Charles Platkin, editor of DietDetective.com. and the director of the Hunter College NYC Food Policy Center. The study provides the calorie/nutrient information, “best bets” and gives each airline a “Health Rating.” This year, Air Canada and Alaska Airlines win the top spot as the airline with the “healthiest” food choices in the sky with Delta and JetBlue in second place.

Airline Food Study 2020 

Survey provides travelers with the
best in-flight food choices, including health ratings to make healthier choices 35,000 feet in the air Air Canada and Alaska Receive Top Rating
NEW YORK, NY (December 19, 2019). There will be more than 47 million passengers traveling during the holiday season (Dec. 19 – Jan. 5) according to Airlines for America (A4A). Knowing the “best” and “worst” choices is a valuable tool for any traveler, so Dr. Charles Platkin, editor of DietDetective.com and the Executive Director of the Hunter College NYC Food Policy Center, once again studied the best “Calorie Bargains” and “Calorie Rip-offs” at 35,000 feet.   DietDetective.com and the Hunter College NYC Food Policy Center have released the 2020 Airline Food Study, rating foods for eleven (11) airlines. The study assigned a “Health Score” (5 stars = highest rated, 0 star = lowest rated) based on criteria including healthy nutrients and calorie levels of meals, snack boxes and individual snacks, level of transparency (display of nutrient information, menu online & ingredients), improvement and maintenance of healthy offerings, menu innovation and cooperation in providing nutritional information, overall sodium levels, availability of meals on flights under 3 hours, and our Airline Water Health Score. The study includes health ratings, average calories per airline, comments, best bets, food offerings, costs, and nutrition information (e.g., calories, carbs, fats, protein, sodium and exercise equivalents). See the full study at dietdetective.com   “This year Alaska and Air Canada share the top spot as the airlines with the ‘healthiest’ food choices in the sky, with Delta and JetBlue tied for second,”  says Charles Platkin, Ph.D., JD, MPH,  the executive director of the Hunter College NYC Food Policy Center and editor of DietDetective.com.   Here are the major airline food headlines:
Alaska Airlines and Air Canada pull to the top for a tie this year as the healthiest airlines. 
Average Calories Same as Last Year: The average number of calories per menu item was 373 calories in 2018 and this year it is almost the same at 375 calories. But keep in mind, calories are not everything; the study also looks at the nutrient content of these foods, as well as innovations moving towards healthier, tastier, less expensive and more sustainable choices. 
Alaska Airlines is the clear leader in making strides to minimize its environmental impact. It was the first to replace plastic straws with paper ones and continues to look for eco-friendly substitutions. Alaska has also launched a #FillBeforeYouFly campaign to encourage flyers to bring their own water bottles and fill them up at water-filling stations in the airport to reduce the use of plastic cups and water bottles on board. 
Shame On You Award goes to Hawaiian for not providing ALL their nutritional information for the study, and to the EPA for not providing penalty information on galley water violations when requested. 
Sodium Matters: Sodium is often used by food providers to boost flavor, especially in the air where senses can be dulled. The average airline meal contains more than 800mg of sodium, which is more than 40 percent of the daily limit of 2000mg set by the World Health Organization. Also, note that in addition to health-related concerns, sodium can make you feel and look bloated because you retain extra water. Watch out for high levels of sodium throughout all airline menus.
Mini-Meals: Full meals or “mini-meal” options are better bets than eating individual snacks, which generally have little nutritional value. 
Short Flights Matter: We urge airlines to provide meals or allow for preorder on shorter flights so that passengers have the option to eat a healthy meal no matter how long they’re in the air. Keep in mind that a 90-minute flight can easily turn into a 5 or 6 hour travel experience when you include getting to the airport, TSA lines, waiting for the flight to take off, deplaning and getting to your final destination. 
You Need to Know: We believe transparency around food is important for airlines. This means providing an up-to-date version of its menu online with all nutrient information  (i.e., calories, fat, carbs, sugar, fiber, protein and sodium), including ingredients. 
Taste Changes in Air: Research shows that our taste perception changes while in flight. Dr. Charles Spence from the University of Oxford found that the three factors impacting taste at such high altitudes are the lower cabin air pressure, lack of humidity and loud background noise. In-flight, air is recycled every few minutes and humidity is normally about 20 percent (compared to indoor relative humidity of 40 percent). With lower humidity and air pressure, we’re likely to be thirstier, and there’s naturally less moisture in the throat, which slows the transport of odors to the brain’s smell and taste receptors. Drink a lot of water. More salt, sugar and flavor enhancers (i.e. spices and herbs) are necessary to make meals inflight taste the way they do on the ground. 
Watch Your Carbs: Eating lots of heavy carbs such as pasta with thick, dense sauces, breads, muffins or cakes will leave you feeling lethargic, cranky and not full or satisfied.  Your blood sugar levels will spike and then fall, which will negatively impact your mood. The fact that food impacts mood, attitude and behavior has been well documented in scientific literature.
Water Watch: This year we published an Airline Water Study highlighting the quality of water provided onboard. Each airline was given a Water Health Score, which has been factored into their overall score in this study. The study revealed that the quality of drinking water varies by airline, and many have provided passengers with unhealthy water. In general, it’s probably best to avoid drinking coffee and tea on board since they are made with galley water. 

Here are the food-service offerings from several of the more popular airlines, along with Diet Detective’s comments, ratings (Health Score: 5  = highest rating), calories, exercise equivalents (amount of walking required to burn off the food consumed) and personal favorites. 
Summary of Health Ratings (5 is highest): Air Canada 4.0, Alaska Airlines 4.0, JetBlue 2.9, Delta 2.9, United Airlines 2.7, American 2.7, Frontier 2.0, Allegiant Air 1.9, Spirit Airlines 1.9, Hawaiian Airlines 1.9, Southwest Airlines 1.7
Air Canada Cooperation in Providing Nutritional Information: Very Helpful Health Score: 4.0 / 5    Fleet Size: 372 Onboard Water Health Score: N/A Average Calories Overall (Individual Snacks, Snack Boxes, and Meals): 347 Average Individual Snack Calories: 308 Average Snack Box Calories: 590
Average Meal Calories: 376 Average Sodium Content Overall (Individual Snacks, Snack Boxes, and Meals): 544mg
Comments: The good news is that Air Canada has added several new items that show some serious health innovation, including the Grilled Chicken Summer Salad and the Wild Rice Superfood Salad. These are great mini-meals, much better than a traditional snack, and are low in calories with great nutrient content. Air Canada also offers a Bento Express sushi California roll. And then there is the Freshii menu, which  provides lower-calorie and higher-nutrient meal choices packed with more vegetables than many other airline options. Air Canada’s meals are relatively healthy and available for trips that are more than 2 hours long. Providing real meals starting at 2 hours is not typical; most airlines start offering real meals at 3 or 4 hours, which is not great if you want to avoid unhealthy snacks. The bad news is that Air Canada needs to include all nutrient information and ingredients on its menu and online – there is no reason not to.The average sodium content of 544mg for all of Air Canada’s offerings is almost ten percent higher than the average among all airlines. However, the average sodium content for meals, at 620mg, is lower than the overall average for all airlines, which is 823mg.  Air Canada also has a larger selection of food items overall, which allows for several healthy options.  Best Bets: For breakfast, the Liberte Greek yogurt is still a good choice and will probably fill you up. The Avocado Smash Box, with fresh guacamole, hard-boiled egg, green apple slices, and multigrain muesli bread sounds amazing and also offers 23g of filling protein to keep you energized. You might want to skip the cheese though.  Other best bets would be the new Grilled Chicken Summer Salad and the Wild Rice Superfood Salad, both of which are relatively low in calories and high in protein for a mini-meal. The chicken salad has 220 calories and 14 grams of protein (which helps to keep you full longer), and the wild rice is a close second with 260 calories and 8 grams of protein. The Campbell’s Chicken Noodle Soup is a low-calorie choice for a snack that will fill you up, but be wary of the 950mg of sodium if you are salt sensitive. The Celery & Carrots with Ranch Dip (if you use no more than half the dip) is still an OK choice. The Sabra Hummus is an OK choice if you share it, and the Sabra Guacamole appears to be healthy, but the Tostitos offer little nutritional value. The Krispy Kernels Natural Almonds come as a large portion but are still a better choice than most of the individual snacks.If meals are available, the sushi California roll is a good choice.  The Pangoa Bowl and the Sriracha Lime Wrap are both high-nutrient/ low-calorie choices. Skip the Smoked Meat Sandwich, since it has nearly an entire day’s worth of sodium along with a high calorie content.  And Air Canada needs to offer at least one healthy kids’ meal.  Alaska Airlines
Cooperation in Providing Nutritional Information: Very Helpful Health Score: 4.0 / 5    Fleet Size: 335 Onboard Water Health Score: 3.3 / 5 Average Calories Overall (Individual Snacks, Snack Boxes, and Meals): 359 Average Individual Snack Calories: 265 Average Snack Box Calories: 464
Average Meal Calories: 388 Average Sodium Content Overall (Individual Snacks, Snack Boxes, and Meals): 472mg
Comments: Alaska Airlines has a variety of snacks, snack boxes, and meal offerings that include some better-for-you options. We applaud Alaska’s transparency compared to other airlines, because its full menu and complete nutritional information are available online, and on Alaska’s app. However, the full ingredient list for each offering is still missing from the website. Although there are improvements to be made, Alaska Airlines has been a clear leader for the past several years, and continues to be committed to healthy food. However, we’d like to see more of the airline’s healthier options, some of which are now available only on flights of more than three hours, available on shorter flights as well.Still, the average number of Alaska’s overall calories is 45 fewer than last year, and the average sodium content, which is 472mg overall, ranks close to the average of 497mg for all foods among all airlines. One highlight is that Alaska is allowing for preordering of foods on their mobile app as well as on their website, so that passengers can reserve healthy foods in advance. Alaska is also a clear leader in environmental initiatives. It was the first airline to replace plastic straws and has launched a #FillBeforeYouFly campaign to encourage flyers to bring their own water bottles and fill them up at water-filling stations in the airport to reduce the use of plastic cups and water bottles on board (do not refill your water bottle on board).  Best Bets: Among the snack boxes, the Mediterranean Tapas hasn’t changed much from last year and is still the healthiest choice. It has olives, hummus, almonds, dried fruit and even a dark chocolate bar. But keep in mind that 545 calories is a bit high for a “snack,” so it would be best if you either shared the box or had it as a meal replacement. For kids (and their parents, because of nagging), the Kids’ Choice Picnic Pack may be tempting, but it’s always better for children (and adults) to eat a real meal.Among individual snacks, the Beef Jerky is low in calories but very high in sodium. The Umpqua Oats Organic Apple Cranberry & Nut Oatmeal has 255 calories and 8 grams of protein, which makes it a healthier choice overall.  The breakfast offerings are a bit heavy and calorie-rich. The Fresh Start Protein Platter has 27 grams of protein, which is high (a good thing) for the number of calories in the platter (340 calories). The Signature Fruit and Cheese Platter also has 27 grams of protein; however, it also has 85 percent of the total amount of saturated fat you should have in a day, so you might want to skip half the cheese. And while you’re at it, maybe skip half the crackers as well. There are fewer lunch/dinner choices this year, but the Fall Harvest Salad is a high-protein, low-calorie choice. When available, the Charge Up Protein Platter is also a great high-protein option.  JetBlue Airways Cooperation in Providing Nutritional Information: Very Helpful Health Score: 2.9 / 5   Fleet Size: 254 Onboard Water Health Score: 2.6 / 5 Average Calories Overall (Individual Snacks, Snack Boxes, and Meals): 295 Average Individual Snack Calories: 120 Average Snack Box Calories: 392 Average Meal Calories: 460 Average Sodium Content Overall (Individual Snacks, Snack Boxes, and Meals):547mg
Comments: The best thing about JetBlue is that it posts all its nutritional information on its website; however, as of this study the information is not up-to-date.  JetBlue has a few reasonably healthy meals on their EatUp Cafe menu; however, they are not offered on flights under 3 hours – not great. At least there are a few OK snack box choices that are available on flights of more than 2 hours. The airline needs to work on this.  In addition, all JetBlue’s free snacks are unhealthy choices. I only wish that the airline would include apples and bananas in those snack baskets the flight attendants pass around.  At least try it once. I would pay for the experiment (on one or two flights). The average number of calories in JetBlue’s food offerings has decreased from 323 last year to 295 this year – nice. However, the average sodium content of all food items is 547mg, which is higher than the average of 497mg across all airlines.  Best Bets: The complimentary snacks aren’t high in calories but they’re low in nutritional value. The best bet would be to choose anything BUT the chocolate chip cookies. It’s hard to believe, but Cheez-Its made with whole wheat flour and having only half the calories of the original version might be an OK choice compared to the others. Too bad. The problem is that the snacks are free; but that doesn’t mean you need to take more than one. As for the EatUp boxes, the PickMeUp is lowest with 300 calories, but it’s not necessarily the most nutritious. The SavorUp box features hummus, multigrain crackers and bean dip with Greek yogurt, and while it’s high in calories, it’s also loaded with good nutrition (e.g. fiber and protein).  Also the FuelUp box is reasonably good, with almonds, dried apricots, apples, and an RX Bar. Have it as a meal though, not as a snack, and skip the biscotti to reduce low-nutrient calories, or share the box with a traveling companion. If you’re on a flight that offers the EatUp Café, the Fresh Fruit and the Jicama and Grape Salad Shaker are very good choices. Skip the Ham & Cheese Croissant, which is very high in calories and sodium. Delta Airlines Cooperation in Providing Nutritional Information: Very Helpful Health Score: 2.9 / 5    Fleet Size: 916 Onboard Water Health Score: 1.6 / 5 Average Calories Overall (Individual Snacks, Snack Boxes, and Meals): 424 Average Individual Snack Calories: 172 Average Snack Box Calories: 560 Average Meal Calories: 495 Average Sodium Content Overall (Individual Snacks, Snack Boxes, and Meals): 780mg Comments: It is nice that Delta provides our team with all the nutritional information for all foods, including sugar grams – nice.  However, as we said last year, we would still like Delta to post all nutritional information and ingredients for every meal–NOT just the Luvo Performance Kitchen meals–online and on its menu. Delta does include labels that alert people who have  dietary restrictions (i.e. gluten-free, Kosher, vegetarian). However, full nutrition information should be accessible for improved transparency. We also urge Delta, and all airlines, to follow Air Canada’s lead and  include meals on flights of under 1300 miles or 3 hours in the air. Options like salads or other lighter fare are important even on shorter flights. If the airlines are worried about food waste, they can have passengers preorder. Delta continues to work with Luvo’s Performance Kitchen line, which has a very strong commitment to healthy eating. The bad news is that the Performance Kitchen items are no longer being offered as complimentary meals, and the remaining free meal options are not as healthy.    Delta’s overall calorie average, now at 423, is 76 calories lower than it was last year – nice. But the average sodium content for all its food items is 780mg, one of the highest of any airline.  Best Bets: For a snack, your best bet is the almonds, and you’ll be surprised by how filling they are. Don’t be fooled by the “whole grain” Cheez-It crackers – not a great choice even for free.  Among snack boxes, the Tapas Box is an OK choice. Skip the rest of them. For breakfast, not the best choices, but it would probably be best to go for the Protein Box. Just eat only one of the two cheese offerings, and have it as a meal.  For lunch and dinner, go for whichever of the Performance Kitchen meals are offered in the direction you’re flying  – eastbound or westbound. The Mesquite-Smoked Turkey Combo is heavy on calories, carbs, and sodium. Among the complimentary lunch options (offered on cross-country flights) there is only one OK choice, which is the Tillamook Cheese and Fruit Box. For the complimentary dinner options (on cross-country flights), the Sesame Noodle Salad and the Greek Mezze Plate are good choices; however, they come with the Tillamook Cheese and Fruit Box, which starts to get extremely high in sodium and calories. So if you choose that option, offer the cheeses to someone else. As for the complimentary dinner meals, avoid the Beef Pastrami Sandwich, which packs enough calories for two meals and a whole day’s worth of sodium. If your sandwich comes with a cookie, save the calories and give the cookie away.
United Airlines Cooperation in Providing Nutritional Information: Somewhat Helpful Health Score: 2.7 / 5    Fleet Size: 786 Onboard Water Health Score: 1.2 / 5 Average Calories Overall (Individual Snacks, Snack Boxes, and Meals):320 Average Individual Snack Calories: 186 Average Snack Box Calories: 463 Average Meal Calories: 431 Average Sodium Content Overall (Individual Snacks, Snack Boxes, and Meals): 464mg

Comments:  United is improving for sure. The airline’s average calories for all food items are significantly lower this year than they were last year, and the average sodium content is 464mg, which is lower than the average across all airlines. Also, the average meal calories are very reasonable at 431. The bad news is that there is no nutritional information on the website, no ingredients list, and United is still lagging behind other airlines on the environmental front (still using plastic straws and cups).  Best Bets: The Beef Jerky and the Hummus are the only good bets for snacks. None of the complimentary snacks are healthy options, but if you must indulge, choose the pretzels. Get the Tapas snack box, which is high in calories but has many healthy foods, including almonds, olives, hummus and bruschetta; just toss out the cheese spread, and share it unless you’re eating it as a meal. Skip the Classic and Select snack boxes, and say no to the kids’ snack box.  For breakfast, the Overnight Blackberry Vanilla Oats is an OK choice, but it does have 41g of sugar, while the Egg White & Chicken Sausage Flatbread Sandwich, with only 310 calories and 21g of protein, will keep you full longer.  Avoid the Egg White Sandwich if you’re sodium-sensitive. For Lunch/Dinner, the Mezze Sampler, which has lots of veggies, hummus and grain, is your best bet.   American Airlines Cooperation in Providing Nutritional Information: Mostly Helpful Health Score: 2.7 / 5    Fleet Size: 968 Onboard Water Health Score: 1.5 / 5 Average Calories Overall (Meals, Snack Boxes and Individual Snacks): 481 Average Individual Snack Calories: 144 Average Snack Box Calories: 471 Average Meal Calories: 585 Average Sodium Content Overall (Meals, Snack Boxes and Individual Snacks): 678mg
Comments: With more than 900 planes, American is a leading airline and should certainly make a more concerted effort to provide healthier food choices. We like its continued partnership with Zoe’s Kitchen, a clean food company focusing on a Mediterranean diet, and we are glad the airline dropped the chocolate in the Hummus Duo, lowering the calories by 140 to a reasonable number, but they still need to serve healthier food. The Vegan Snack Box is good news, not just because it’s vegan but because of the nice offerings it includes. The bad news is that the airline is still not publishing a menu with nutritional information on its website — not good. Nor did American provide us with complete nutrition information (e.g. carbs, fats, protein and sodium). We appreciate the airline’s responsiveness, but given its size, it should have healthier menu options and provide online menus with full nutritional info and ingredients. Pringles are the only snack offered for purchase, not good. Come on, American–healthy food is good business, Have you heard of Whole Foods? Overall, American’s calories have increased from 417 last year to 481–not the right direction.  And the sodium levels, at an average of 922mg for meals, is much higher than the already high average of 823mg for all airlines that serve meals. (Note: 2000mg is the World Health Organization’s daily limit.) Best Bets:  The Continental Breakfast offering with Chobani Yogurt is a good choice (only available until Dec 1st, after which it’s replaced by a high calorie Belgian waffle).The Breakfast Platter is an OK choice with hardboiled egg and apple slices, and on cross-country flights to/from San Francisco or LA and NYC, the complimentary Vegan Snack Box (oats) is a decent option. If you purchase lunch or dinner, the Harissa Chicken Wrap (without the cookie) seems to be the best option. The Hummus Duo is higher in calories and sodium, but it can be a good choice to share between two people unless you eat it as a meal. The lunch/dinner version of the Vegan Snack Box (hummus) is also not bad if you’re flying to/from San Francisco or LA and NY and you eat it as a meal. If you’re trying to eat healthy, skip the chocolate chip cookie in all meals that come with one – it’s 200 calories, and not worth it. Avoid all the free or paid individual snacks and/or snack boxes except for the two complimentary vegan boxes on flights where they are available (transcontinental). 
Frontier Airlines Cooperation in Providing Nutritional Information: Very Helpful Health Score: 2.0 / 5    Fleet Size: 91 Onboard Water Health Score: 2.6 / 5 Average Calories Overall (Individual Snacks and Snack Boxes): 289 Average Individual Snack Calories: 298 Average Snack Box Calories: 257 Average Sodium Content Overall (Individual Snacks and Snack Boxes): 367mg

Comments: Frontier was incredibly responsive, providing information quickly – nice. However, it would be great if the airline offered some healthier items. The average calories in their inflight offerings decreased for each category this year, but there is still room for improvement as to what those offerings could be. Again, Frontier is an innovative airline – please apply that innovation to food. The sodium content of its snacks is 367mg, which is much higher than the average for snacks across all airlines. And the average number of calories in its snacks is 298, which is 15 percent higher than the average across all airlines. 
Best Bets: The best bet for snacks is to choose the KIND bar or the Jack Links Beef Steak (as long as you’re not sodium sensitive). Neither of the bundled snack boxes provides a nutrient-rich, low-calorie option.
Allegiant Air Cooperation in Providing Nutritional Information: Very Helpful Health Score: 1.9 / 5    Fleet Size: 91 Onboard Water Health Score: 3.3 / 5 Average Calories Overall (Individual Snacks and Snack Boxes): 325 Average Individual Snack Calories: 390 Average Snack Box Calories: 240 Average Sodium Content Overall (Snack Boxes and Individual Snacks): 362mg
Comments: The good news is that Allegiant was very helpful throughout the study. Nice job!    And compared to last year, it has lowered its overall calorie average slightly, from 336 to 326 calories. It would be wonderful if the airline added a few more nutritious food items to the menu, perhaps an apple or a salad shaker. Best Bets: Among the individual snacks, the nuts might work if you shared them with at least one other person. The Hummus Snack Pack is also OK.  Avoid the Deli Snack Pack, and the Wingz Kids Snack Pack is not a healthy choice
Spirit Airlines Cooperation in Providing Nutritional Information: Very Helpful Health Score: 1.9 / 5    Fleet Size: 135 Onboard Water Health Score: 1 / 5 Average Calories Overall (Individual Snacks and Snack Boxes): 360 Average Individual Snack Calories: 370 Average Snack Box Calories: 319 Average Sodium Content Overall (Individual Snacks and Snack Boxes): 450mg
Comments: Spirit’s inflight offerings were hard to find on the airline’s website. No nutritional information is provided for the food offered, and, overall, there are not many (if any) healthy options. The good news is that the airline responded incredibly well to our queries–nice.
The average sodium content of Spirit’s snacks is 403mg, which is well above the average across all airlines. The airline’s average individual snack calories are also significantly higher at 370 than the 255 average across all airline snacks.
Best Bets: The FlyFit Protein Mix of nuts would be a good bet if split among four people, because each bag contains about four servings of nuts. The Nissin Cup Noodle Very Veggie Chicken Flavor is OK at 330 calories and might feel like a real meal, but it’s very high in sodium. The Cheese Tray is a much better choice than the Cafe Snack Box, but it would be better shared between two people. It’s too bad that the Quinoa with Artichoke & Roasted Peppers is no longer on the menu, because it was a healthy and satisfying snack option. 
Hawaiian Airlines Cooperation in Providing Nutritional Information: Not So Helpful Health Score: 1.9 /  5    Fleet Size: 57 Onboard Water Health Score: 3.1 / 5 Average Calories Overall (Individual Snacks, Snack Boxes, and Meals): 556 Average Individual Snack Calories: 369 Average Snack Box Calories: 515 Average Meal Calories: 898 Average Sodium Content Overall (Individual Snacks, Snack Boxes, and Meals): 755mg
Comments: This year, Hawaiian Airlines showed a tiny bit more effort, but, to be honest, it is now the ONLY airline that does not provide us with complete nutrition information. Much of the meal nutrient content had to be estimated by our registered dietitians, and the information provided by Hawaiian was confusing. There are a lot of high-calorie and high-sodium options, and many of the snacks will not be satiating. If you are flying Hawaiian it’s very important to note that ALL meals are free, and they are large, and there is a lot of food provided during flights from or to Hawaii – anywhere from 1122 to 1514 calories, and 1338 to 2453 milligrams of sodium. Those are very unhealthy numbers. The average sodium content of all Hawaiian’s food offerings is 775mg, which is way above the average across all airlines.  Best Bets: Among the snacks, choose the Kitchen & Love Quinoa with Artichoke and Roasted Pepper Quick Meal. That’s it for healthy snacks; pass on all the others.  Among the snackboxes, the Gluten Free Box has some healthy components, including the hummus, chickpea snacks, and the turkey stick. But skip the fruit snacks, and the cookies. For meals, it’s much more complicated. NYC/Boston to Hawaii and Hawaii to NYC/Boston are long, 10-hour-plus flights, and food service includes several free meals throughout. The actual meal is OK; however, you should avoid all the free-meal extras, including the chips, the pineapple coconut treat, potato salad, cole slaw, cookies, cheese, crackers, snack mix, and alcoholic beverages.  If you do insist on eating all the unhealthy “extras,” they will leave you feeling tired and uncomfortable. 
Southwest Airlines Cooperation in Providing Nutritional Information: Somewhat Helpful Health Score: 1.7 / 5    Fleet Size: 754 Onboard Water Health Score: 2.4 / 5 Average Individual Snack Calories: 106 Average Sodium Content Overall (Individual Snacks): 135mg
Comments: For one of the top carriers, Southwest does not offer much variety or nutritional value. If the airline really does have a heart (as  it does on its logo), it would care about the food that’s being served. Southwest needs to add some healthy snacks. And this year, for the first time in 20 years, the people we contacted were not nearly as helpful as they usually are in providing information for the study. The communications team’s kindness was its only saving grace. The airline’s average calories for snacks has decreased from 138 last year to 106 this year. The average sodium for the few food offerings is low at 135mg. Best Bets: The pretzels are the only reasonable choice, they but have no nutritional value. More than on any other airline, when you fly Southwest, you need to bring your own fresh, nutrient-dense, healthy food, such as nuts and fresh fruit.   ###

Mashed Bananas, Dettol and Maternal Health

Last week I headed back out into the Western Region with the Pro-Link team for another Healthy Mother & Child training session with nurses from various district health facilities. We also delivered some of the IEC (Information, Education and Communication) materials which included posters about breastfeeding and staying away from using herbs to trigger contractions. HalfAssiniBreastfeedingPoster
Director Trudi Nunoo spoke with various district health personnel about the Mummies, Daddies and Adolescent clubs which educate about maternal health and provide ideas for local communities to prevent dangerous situations, such as lack of transportation to clinics. This is a real problem for some of the more rural communities. When a woman is facing birth complications often she can’t get a taxi to take her due to lack of money and also because of the mess she might make in the back seat. Communities are working out various ways to raise funds and have a reliable transport referral system. Drivers want to know they’ll get paid, plus they want Dettol to clean up and disinfect their vehicles. In some areas churches are working on ways to get the funds and in others it’s the nurses.
I was lucky to witness a Child Welfare Clinic in Essiama with Ellembelle District Public Health nurse Judi Okine. Judi was there to give a presentation to mothers on nutrition and the best foods to use when weaning a baby off breast milk after they’re six months old. She laid out a table with a blender to create a watermelon juice, and also demonstrated how babies can eat mashed yams and mashed bananas. I was privileged to watch the weigh-in and some vaccinations (not popular with the little ones).

Judi gives moms nutrition tips at Essiama market.

Judi gives moms nutrition tips at Essiama market.

Another focus of the trip was to check in on the construction of some maternal health facilities. In Nkroful, we saw that the health centre was almost complete…I’m sure a relief to the moms who have had to give birth in a temporary set up next door.
Entrance to the temporary birthing room.

Entrance to the temporary birthing room.

NkrofulDeliveryBedNkrofulMothersA very cool trip giving me lots more insight on the Healthy Mother & Child project.

Miracle Moringa Trees Could Help Haiti

I posted this story about moringa trees in Haiti recently on the Innovate Development site. Will check the study at year end to see what they have found.

HERhealth project: Supporting factory workers in Vietnam.

With capacity building about health, hopefully women can take more control over their own bodies.

With capacity building about health, hopefully women can take more control over their own bodies.

This is a link to a piece I wrote describing HERhealth for Innovate Development – it’s a program that helps educate women factory workers about their health….

The irony that is Swaziland

Before Christmas, there was a so-called “Mini-Skirt” march in Manzini to bring attention to the fact that women are harassed and even raped at the bus rank for wearing short skirts. Police said they could only march if they put on longer skirts…so the girls did, and then did a big rant in Jubilee Park, “Sister sister, my vagina belongs to me and nobody else.” Here’s the fruit of their labours..a law banning mini skirts, but not the annual ceremony before the king where everything hangs out. What a country! Check this link..

Mini Skirt March in Manzini, Dec. 7, 2012. Police said they could only march if they put on longer skirts, long shorts or pants.

Official costume at Umhlanga, where maidens dance for the King, and many, many Chinese tourists.

The King, the police and the tourists are all good with the official attire at Umhlanga, the annual Reed Dance ceremony.

Why HIV/AIDS is so prevalent in Swaziland

Explaining the connection between GBV and HIV/AIDS to dignitaries at the Mavuso Centre in Manzini.

On Friday, Nov. 30, Swaziland celebrated World AIDS day with a march and a presentation for 500 people at the Mavuso Trade Centre in Manzini. Two thirds of the people in attendance were from government, including police and correctional services.

I lined up for the march at 8 am and got one of the few remaining t-shirts, which a staff member at SWAGAA quickly commandeered from me when she didn’t receive one. Oh well, I didn’t come to Swaziland for the t-shirts.

Swaziland has the highest prevalence of HIV/AIDS in the world. The SDHS 2007 study showed that 26 percent of the population aged 15-49 was infected with HIV/AIDS. Anti retroviral drugs have improved the average lifespan from around 33 in 2006 to around the mid-to-high 40s today. I use the word “around”  because health care practitioners here have told me the statistics are notoriously unreliable.

At a meeting led by the National Emergency Response Council on HIV and AIDS, (NERCHA) that I attended prior to this year’s World AIDS Day events, we were told, “Don’t use the word ‘success’ but ‘achievements.’ We still have a long way to go.” An article in the newspaper the same day said the 75 percent of deaths in Swaziland were due to AIDS.

SWAGAA had an exhibitor’s stall at the event and we handed out information about gender-base violence. When dignitaries came to our booth, I told them about the link between gender-based violence and HIV/AIDS. It seems obvious, but not everyone thinks about it. When a woman is being beaten or raped, it is unlikely a condom will be used. Tears in the genital area offer an easy pathway for the infection to travel. Then there are the indirect ways GBV is linked to HIV/AIDS. If someone has been sexually abused, especially as a child, they may suffer low self-esteem and become promiscuous or go into prostitution.  Or, they may become drug addicts. This risky behavior can lead to infection.

Why is the HIV virus spreading at such an alarming rate in Swaziland? Most HIV/AIDS organizations  focus on behavior. Swaziland is on the border of Mozambique and South Africa. Truck drivers or migrant workers stopping for causal or paid sex transmit the disease. Then there’s something called Multiple Concurrent Partners (MCP). Many people sleep with a few partners at the same time. This could be transactional sex, to help pay for school fees or groceries. It might be to pay back a cheating partner; it might be due to loneliness when a partner spends months away on work contracts. Swaziland has high unemployment. It’s expensive to live here and school fees for rural people, dependent on subsistence farming, are high. Then there is patriarchy and polygamy. There are many prevalent scenarios. Men feel it is their right to have multiple wives and yet often they are unable or unwilling to take care of them, and their children. Young girls become pregnant and have no support from their families or the man who made them pregnant. Women are discouraged from talking about sex culturally, so often there is sexual dissatisfaction in a marriage. The spiral goes on and on.

Here are some quotes from Swazi participants in a study published in Onelove, a 2008 10-country research report funded by Irish Aid, DFID, and the European Union amongst other donors. The report says young people are often pressured by their peers to acquire material possessions they cannot afford and so they become involved with an older person who provides these things in exchange for sex. Here, it’s called ‘Intergenerational sex.’ A participant noted, “It’s the relationship between teachers and students yet the teacher has got a wife or a girlfriend and at the same time the student has got a boyfriend.” The report also noted that polygamy and gender inequality create serious power imbalances that fuel MCP.

HIV/AIDS continues to spread in Swaziland, but not at quite the pace of the mid-2000s. Achievements, not success. The big theme at  this year’s event  was about getting to zero infections. Tackle the root causes of behavior and there might be a chance.