The fight you lose in a hotel restaurant

You can lose a fight without being hit. Three days out, in a hotel bathroom, dehydrated on top of a cut you were already running, with nothing left to give on the scale and nothing left to give in the ring.

Nobody plans for this, and it is one of the most likely things to happen to a fighter who competes abroad.

I have travelled to camps and competitions for two decades. This is the risk I take most seriously and talk about least, which is a mistake I am correcting here.

How likely it actually is

A systematic review with meta-analysis pooled 10 cohort studies covering 8,478 short-term travellers from high-income countries.

The incidence of travellers' diarrhoea was 36.1 percent, with a prediction interval running from roughly 20 to 56 percent depending on the destination and the study.

By severity: mild in 23.6 percent, moderate in 8.1 percent, severe in 2.9 percent.

More than a third. That is the baseline you work against every time you fly somewhere to fight, and it is higher than most fighters would guess.

Risk factors identified include younger age, longer trips, destinations in low and middle income countries, and pre-travel health status. A fight camp abroad ticks several of those before anybody has eaten anything.

What three rules did

Now the study that should change how a team travels.

An England squad at an international youth games in India implemented evidence-based hygiene guidelines and audited the result.

On the reconnaissance trip beforehand, without guidelines, the rate was 7 out of 14. Fifty percent.

With the guidelines in place, across the full squad of 122, it was 24 cases. Twenty percent.

The guidelines were not complicated. Drink only bottled water. Eat only hot food. Wash hands regularly with alcohol gel.

Three rules, and the rate more than halved.

I want that understood clearly, because the instinct here is to reach for a supplement or a pill. Among the measures actually recommended for travellers, behaviour applied consistently across a whole squad produced the largest documented effect in this setting.

The antibiotic that is wrong for you

The part specific to combat sports is not widely known.

In that same audit, ciprofloxacin was offered as prophylaxis to non-athlete members of the team, and deliberately not offered to the athletes. The stated reason was its possible association with tendon disease.

Fluoroquinolone antibiotics carry a recognised risk of tendon injury, including rupture. For a fighter, whose hands, shoulders and Achilles tendons are the equipment, that is not a footnote.

More broadly, routine antibiotic prophylaxis for travellers' diarrhoea is not recommended, because of resistance and side effects. It is considered only in narrow circumstances, and elite athletes are named among them precisely because the consequences of illness are disproportionate.

That remains a decision for a doctor who knows what you do.

The point for you is simpler. If somebody hands you an antibiotic abroad, find out which one before you take it, and tell them you are a combat athlete.

Why it is worse for you than for a tourist

A tourist with travellers' diarrhoea has a ruined week. A fighter has a compounding problem.

You are already dehydrating on purpose. Illness adds fluid loss you did not plan and cannot control, on top of a deficit you designed. The two do not add, they multiply, and the warning signs that would normally tell you to stop the cut become indistinguishable from the illness.

Then there is the misreading. The scale drops. For a fighter 3 kilos over, that can briefly look like good news.

What leaves is fluid and gut content, going out of a body with no reserve, days before it has to perform, and it returns the moment you rehydrate. None of it is the weight you wanted to lose.

Anybody treating an illness as a head start on the cut has misunderstood what just happened to them.

Travel and travellers' diarrhoea are also associated with changes in the gut microbiota, often including reduced diversity that may persist for some weeks after symptoms stop.

The findings are not uniform across studies, but the effects do not necessarily end when the toilet trips do.

The rules I actually give

• Water. Bottled, sealed, opened by you. That includes the water you brush your teeth with, and the ice in your drink, which is the one people forget. Ice is water somebody froze, from wherever they got it.
• Food temperature. Hot food, served hot, cooked through. Not warm, not sitting under a lamp, not reheated buffet.
• Raw is out. Salads, leafy vegetables, raw or undercooked seafood, fruit you did not peel yourself. This is much the same list fight week already asks you to drop for other reasons, which makes it easier than it sounds.
• Street food is out for the duration. Not a judgement on the food. A judgement on the timing.
• Hands. Alcohol gel, carried on your person rather than left in the room, used before every meal. One of the three rules that halved the squad rate.

Buffets deserve their own line. A hotel buffet is food that has been out for an unknown period at an unknown temperature, touched by an unknown number of people.

Take from hot service if there is one, and eat early in the service rather than late.

What goes in the bag

Oral rehydration salts, more than you think you need. They are already in your kit for after the scale, and they are the front-line response here too. Make them up with bottled water.

Alcohol hand gel, in the bag you carry rather than the case you leave behind.

Familiar food for the first days: your own oats, rice, protein powder, whatever forms the base of your normal camp. The plane is a bad place to discover the destination has none of it.

On medication, one reassurance and one instruction. The common over-the-counter anti-diarrhoeal medicines are not on the Prohibited List, so being tested is not a reason to refuse treatment. But formulations differ between countries, and combination products contain things the name does not advertise, so check the specific product on Global DRO in the country you are standing in.

If it happens anyway

Rehydration first, with oral rehydration solution rather than plain water, for the same physiological reasons that apply after a weigh-in.

Stop the cut and tell somebody. This is where a fighter's instinct to say nothing does the most damage.

A cut running alongside an untreated illness is the scenario in which the serious incidents in this sport happen.

See a doctor rather than a teammate's opinion, and mention both that you are tested and that you are a combat athlete. Those two facts change what should be prescribed.

And accept that the fight may move. That decision sits above my level and above yours, but it should be made on accurate information rather than with a fighter hiding symptoms until the weigh-in.

The unglamorous conclusion

Everything on this page costs nothing and requires no product.

Sealed water, hot food, clean hands, no ice, no buffet gambling. A squad following rules of that shape cut its illness rate by more than half, and no supplement discussed anywhere on this site has produced a result of that size.

The most valuable nutrition work I do abroad is making sure the athlete is still able to eat the plan, which matters more than building it.