We rarely consider our gut health and diet when moving abroad. Before leaving, our minds are consumed with travel preparations. The initial phase of expat life often coincides with a honeymoon period. Then comes the necessary adaptation, where daily life takes over. "The Expat Gut Health Survey: How Symptoms Can Impact Life Abroad," a study by Allianz Care, published on May 29, surveyed over 3,000 expats worldwide and unveils the link between gut health and quality of life.
New environment and eating habits
Adapting to a new country's food system might seem straightforward at first. Unlike learning a new language, you don't need to sign up for classes; the stomach will adapt on its own. Few expats consider their gut health. The new job quickly sets its pace, and expats prioritize urgent matters. Culinary exploration starts at the local grocery store, with microwaves and processed foods replacing home-cooked meals. These dietary changes can significantly affect gut health and overall quality of life abroad, as highlighted in the latest study by Allianz Care, a global leader in international health insurance, in partnership with Densu, a global communications giant.
From October 9 to December 21, 2023, 3015 expats responded to the survey. Participants hail from the United States, the United Kingdom, India, the Philippines, Kenya, Italy, South Africa, and Singapore, and were living in Switzerland, the UAE, Qatar, the Netherlands, the UK, or Germany, among others.
37% of respondents have lived abroad for more than five years, while 35% have been expats for less than six months. The survey included slightly more men than women (58% vs. 41%). The main age groups of expats were represented: 30% were aged 35–44, 26% were 25–34, and 20% were 45–54. The majority of expats were married (43%) and parents (23%). 21% were single, and 12% were in a relationship.
Gut issues can affect your quality of life abroad
77% of expats acknowledged that gut disorders disrupt their daily lives, negatively impacting their quality of life. Bloating, cramps, constipation and diarrhea are troublesome symptoms, especially when they become chronic. 40% of respondents experienced these symptoms more than three times a week, while 34% noticed significant variations in their bowel movements from day to day. 20% suffer from regular episodes of coughing, colds, and viral infections, all of which are related to disruptions in the gut microbiome.
The gut microbiome includes the intestinal microbiota and its "activity domain." A healthy gut microbiome plays a crucial role in digestion, nutrient absorption, and immune response. This explains why an unhealthy gut can disrupt overall health. The gut is often called the "second brain" for a reason.
An unhealthy gut and stress: A vicious cycle
Living with gut issues daily is challenging. Going to work, scheduling appointments, or eating out can become a nightmare, especially abroad, where the expat constantly adapts to new surroundings. These inconveniences also affect mental health. 46% of expats reported repeated episodes of stress directly linked to their gut problems, creating a vicious cycle: stress exacerbates gut disorders, which in turn increases stress.
Despite this, few expats talk about their gut issues. Eating is a fundamental and commonplace activity. While healthy food is popular in nutrition books and health apps, discussing gut problems is often avoided due to embarrassment or fear of being misunderstood. After all, aren't you supposed to be having your"dream life" abroad? How do you explain a bloated stomach? The study highlights the importance of addressing these issues to prevent worsening conditions, since solutions exist.
The expat's plate at a glance
Let's look at what expats eat and their lifestyle habits. Despite recognizing the negative impact of gut issues, 88% of expats do not follow a specialized diet.
Only 27% take dietary supplements (probiotics, medicinal herbs, etc.). Supplements can improve gut health, but they must be chosen carefully. To choose correctly, one must start with the basics: what goes on the plate and into the shopping cart.
What do expats eat? What is their lifestyle? Over half (54%) of respondents tried to maintain a varied diet, and another 54% indulged in fast food once a week. This can be acceptable with a balanced diet and regular exercise, but reality often falls short of this ideal. 30% of expats admit to eating the same food every day. Only 16% are true advocates of a varied and colorful diet.
And what about water? 54% of expat respondents said they drink 1-2 liters daily. A majority (44%) abstain from alcohol, while 31% allow themselves one or two drinks a week. This moderate consumption must be viewed alongside other factors, such as exercise and sleep quality. Regarding sleep, most respondents (70%) have good habits, getting the recommended 6-8 hours per night.
Does living abroad really change eating habits?
Living abroad involves dealing with visa and residency procedures, adapting to new corporate cultures, and learning new methods. It also means unpacking boxes, ending leases, and signing rental contracts. Additionally, it introduces you to new foods, cooking methods, and preservation techniques. Is the local cuisine spicy or rich in fermented foods? The stomach may need time to adjust, sometimes facing psychological barriers. Despite their benefits, it can be challenging to accept a plate of grilled grasshoppers.
So, does living abroad really change eating habits? 36% of respondents said no, but nearly as many (34%) reported small changes and 21% noticed significant changes since moving abroad. Most respondents realized they had a more varied diet in their home country and now consume more processed foods. Finding familiar foods can be challenging or even impossible in some countries. 10% of expats found it "very difficult" or "impossible" to find familiar foods.
Changing eating habits based on country of residence
Eating is also a cultural habit. Certain foods are more commonly consumed in specific regions. The study reveals a higher number of respondents in the UK (8.8%), Switzerland (8.4%), Singapore (7.2%), the UAE (6.9%), and Germany (5.7%). Their responses indicate differences in eating habits compared to the overall panel, which can be a source of stress in a new environment.
Except for expats in the UK, half of the respondents from these countries experienced bloating more than three times a week. They confirmed the negative impact of gut issues on their quality of life, with figures ranging from 54% in the UK to 77% in Germany and even 100% in the UAE. Despite this, few adopted a specialized diet. Only 6% of respondents in the UAE adapted their diet, compared to 9% in Germany and 8.5% in Singapore and the UK. Swiss expats were the most likely to adjust their diet (18.5%). All groups emphasized increased attention to gut health since moving abroad, with UAE residents being the most aware (52%), compared to 34% in Singapore.
Expats' well-being: Listening to your microbiome
Changes in eating habits are visible on the waistline. 20% of expats have gained weight, while 10% have lost weight, and 11% suffer from bloating. However, some dietary changes are beneficial. Expats adopting healthy food habits reported reduced sugar, alcohol, and ultra-processed food consumption. They drink more water, eat more fruits and vegetables, and exercise more.
The study underscores the importance of maintaining a healthy diet while living abroad. 42% of respondents now care more about their gut health since moving abroad, with 32% considering it "very important." Many studies link poor gut health with other health problems. Besides stress, respondents worry about mental health (14%), daily gut dysfunction (17%), cancer risks (18%), and obesity (19%).
Balancing expat life and gut health
Observation and curiosity can guide expats from supermarket aisles to the kitchen, where they rediscover the joy of selecting raw products, finding substitutes for familiar foods, and learning to cook local dishes. Fiber-rich foods and fermented products should be included in the diet. Avoid large spoonfuls and take time to savor each bite. Don't forget water and daily exercise. A happy gut ensures well-being.
