The dirtiest spot on an airplane, and tips for staying healthy onboard

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Airlines are looking into new wellness programs for ultra-long nonstop flights, including changing menus to promote hydration. Singapore Airlines is considering healthier, lower calorie options, and substituting starchy potatoes with cauliflower, which has high water content.

“What you want to do is keep blood sugar levels as stable as you can. You need multiple meals — that’s better than having one big heavy meal,” says Scott McCartney, who writes the “Middle Seat” column for The Wall Street Journal. “You want to provide, in some cases, diuretics — things that will make you get up and go to the bathroom because you want to keep moving around.”

How dirty is the bathroom?

Dr. Mark Gendreau, Chief Medical Officer of Beverly and Addison Gilbert Hospitals in Massachusetts, says there’s been a lot of research on the cleanliness of the bathrooms, and they have a high bacterial count.

“Most people think that the seat is probably the dirtiest. It turns out that it’s actually the door knob to get out of the bathroom, as well as the handle to the faucet,” he says.

He cautions people from using the bathroom water to brush your teeth or wash your face — because there’s no way to tell if the water is contaminated or not. He says you need to use bottled water to brush your teeth.

Washing your hands with the water is okay, but it must be 15 seconds of rubbing your hands with the soap.

He recommends carrying hand sanitizer that’s 70 percent alcohol-based. He says he sanitizes his hands with the gel product after using the bathroom.

Is your tray table clean?

When Dr. Gendreau gets onboard, he puts a few drops of hand sanitizer into Kleenex and wipes the tray table, particularly on a domestic flight. “We all see it — you’re waiting to board the aircraft, and as soon as the last person is off, they’re boarding within a five-minute period of time. So they’re not really able to get there and do a very thorough cleaning.” But international flights do get a good cleaning.

Will the air make you sick? 

McCartney says aircraft manufacturers have made air circulation much stronger, especially on newer planes. The air is highly filtered with HEPA filters — almost operating room-quality. “You want to open the air vent, and you want to aim it right in front of your face, so that you get the filtered air. The big danger for people is just breathing what comes out of their neighbors.”

The importance of moving around

Dr. Gendreau says just the position of the seat can slow the return of blood flow in your lower extremities, which can make you susceptible to deep vein thrombosis. You can help avoid that by staying hydrated.

He says you can stand up at your seat and rock back and forth, or walk to the front or back of the cabin a few times. Dr. Gendreau does that every hour on an overseas trip.

Aisle or window?

Dr. Gendreau says when you’re sitting at the window, you’re more apt to stay put, partly because you don’t want to interrupt your fellow passengers. Also, air gets pulled back into that region to be reconditioned.

So the aisle seat is the best, he suggests. And it doesn’t matter whether it’s at the front, middle, or rear of the plane.

“We used to think that the front of the cabin was better air circulation. That’s in the older aircrafts. But the newer aircrafts… the airline industry is very motivated to ensure that ventilation is superior. It’s far better than what you would get in an office building. If the HEPA filters are not properly maintained, they get drag, and that costs fuel, and they are not interested in spending or wasting fuel,” says Dr. Gendreau.

More: The Science Behind the World’s Longest Flights