Tired reporter flight-tests a product to combat jet lag

Thursday, November 30, 2000

By CHRIS ADAMS, The Wall Street Journal

At about seven on a Saturday morning, I am one of 11 tired and slightly irritable travelers walking off an America West red-eye from San Diego to Baltimore. In the past six hours, we have had flight delays and been subjected to electronic mind games at 30,000 feet. Now, the one thing I want is a cup of coffee.

But caffeine isn't allowed. "I tell you, I can smell Starbucks on a person's breath from five yards away," warns a young research assistant named Robert Sitarz, who for 15 hours has watched everything we put in our mouths.

We all are groggy, and that's the way it's supposed to be. In the end we are taken by van to a researcher's office in northwest Washington, where about half of us get our first dose of a dietary supplement called NADH, the others a placebo. We don't know who is getting what. The idea is to see if NADH, which stands for nicotinamide adenine dinucleotide hydrogen, mitigates the effects of jet lag.

If so, it would be a welcome relief to bicoastal executives - and a financial boon to Menuco Corp., in New York, which sells the nonprescription stuff under the brand name ENADAlert and sponsored the research. Studies like these allow companies to plaster the phrase "clinically proven" on their packaging. So Menuco rounded up 35 guinea pigs, subjected them to hassle-filled, cross-country flights, and tested them every few hours to see whose mental acuity breaks down the fastest - the NADH users or the sugar-pill poppers.

I am one of those guinea pigs. This (yawn) is my story:

The ordeal starts the morning of the Friday flight, when a group of 11 healthy men and women, all at least 35 years old, gather in the San Diego office of an otoneurologist named Erik Viirre.

Each of us leaves a urine sample and listens to the rules: no caffeine, no alcohol, no sunlight. Our group is the third to participate in the study, each under the watchful eye of Mr. Sitarz. (The Wall Street Journal paid my expenses, and I didn't accept the $225 participant's fee.)

The trial is overseen by researchers from the University of California, San Diego and Georgetown University School of Medicine in Washington. Only after all three groups are finished will researchers "break the code" to see which pills each subject got.

Nobody among us had heard about NADH before. And, in truth, most of the people recruited in San Diego see the experiment pretty much as a free trip to Washington.

The trip is west to east since jet lag is worse flying in that direction. We're making a stop in Phoenix to ensure that the flights are as annoying as possible. We're to arrive in Washington at daybreak Saturday - theoretically just in time to catch a cab for a meeting with East Coasters who have slept all night in their own beds. The whole experiment, says Dr. Viirre, is designed to mimic "the executive's lousy business trip."

Once equipped with laptop computers, we're promptly subjected to a battery of rapid-fire mind games. Accuracy and speed are paramount. Quick: Is 6 + 7 - 9 greater or less than five? How about 9 - 5 + 2?

The tests take 45 minutes and will be repeated five times over a 24-hour period. We also answer a series of questions about our moods that make us feel like characters in "Snow White and the Seven Dwarfs": Are we "happy," "grouchy," "drowsy," "gloomy," "furious?"

But the "money test," in the words of Dr. Viirre, is a simple game. Shapes flash on the computer and then fade away. Our task is to hit "enter" each time a heart pops onto the screen.

Sounds easy, but not after 10 minutes. "This test is deliberately slow and boring," he warns us. The tests measure subjects' lapses of attention, which can be caused by "microsleep," in which my mind could temporarily shut down even though I am sitting in a chair, with my eyes open. "You can imagine it'll be a lot tougher at midnight," Dr. Viirre says.

During the test, my mind doesn't switch off so far as I can tell, but it does wander. Schuyler Grant, a 44-year-old physicist from San Diego, begins counting each flashing figure, eventually reaching 250 or so.

By 3 p.m., a few participants are yawning madly. We are hustled onto vans for a trip to the San Diego airport and the flight to Phoenix. After we arrive there, we're shuttled to a hotel for dinner and more tests.

As we start eating, there is a small crisis: We have been served a dessert of tiramisu.

"Don't eat that!" Mr. Sitarz commands. Tiramisu has espresso in it.

A waiter swoops down and whisks away the desserts, offering carrot cake instead.

By 11 p.m., we're back at the airport, only to find our departure is to be 90 minutes late. Most of the group sacks out on airport chairs. Terrance Kwiatkowski, a 35-year-old head and neck surgeon, changes into workout clothes and walks briskly around the airport.

We're back on the plane, finally, at 1:30 in the morning. As other passengers try to sleep, we all fire up our laptops and perform the tests again. In the middle of it all the flight attendants offer drinks that most, but not all, of us are too busy to order. By 7 a.m., Eastern time, we are back in a shuttle van, heading to the Washington offices of Dr. Gary Kay.

As we zip down the parkway, Tom Layman, a 49-year-old fire-department battalion chief from a town just outside San Diego, turns to Mr. Sitarz: "I think you're going to get a few more 'grouchy' remarks this time," he says.

Once in the office, Dr. Kay breaks open a case of vials. We each, as instructed, let four little pills dissolve under our tongues.

Then we wait. Then we test. Then we wait some more - and we watch. While previous groups had been offered a sedate selection of "National Geographic" videos, we are given something a little more lively: "Austin Powers: The Spy Who Shagged Me." A few of us laugh at the outrageous gags, while most just stare blankly at the screen, and at least three nod off.

"Fernando," somebody calls out to one of the participants. No response. Fernando is fast asleep, his chin resting heavily on his hand.

"Fernando, wake up." No reaction.

"Fer-naaaan-do." Still nothing.

"I have a sneaking suspicion Fernando got the placebo," offers Mr. Layman, the fire chief.

A few minutes later, Fernando's chin slips off his hand, and his head drops toward his knees.

By 2 p.m., the final test battery is complete. I am pretty sure my test-taking performance has been pretty consistent throughout the 24 hours; I guess it should have been because later, when the code is broken, I learn that I was indeed given NADH.

So did the stuff work? Well, the company's news release, due out Friday, says the NADH group "achieved significantly better performance on tests of thinking and skilled motor activity" and showed a "trend to be less sleepy than subjects who received placebo."

But a scientist's standard for statistical "significance" is more rigorous than my subjective impression. Among the participants in my group, for example, nobody felt noticeably different after taking the pills. (The researchers say that's common; the idea is to restore normal performance, not to jazz anybody up.)

As for the numbers, Drs. Kay and Viirre note, in their article on the research, there were differences in the NADH and placebo groups.

On a test of "working memory," both the groups posted 93 percent accuracy during the first test, in San Diego. On the morning test in Washington (taken one hour after getting the pills), the performance diverged - down to 91 percent for the control group, up to 95 percent for the NADH group. A few hours later, on the last test, the placebo group was 94 percent accurate, the NADH group 95 percent.

On the "money test" - the flashing hearts - the morning test showed no differences (members of the placebo group each averaged 1.6 errors, the NADH takers 1.7, out of 45 possible "targets.") The afternoon test showed the placebo group making 2.3 errors, on average, while the NADH group made 1.1.

An "error of omission" can be important. Says Dr. Viirre: "It reminds me of the air-traffic controller who says, 'Gee boss, I got the last 100 planes in, but I just missed that one.' "

As for the "trend to be less sleepy," it wasn't strong enough to be statistically significant. Nor was the mood test, which showed almost no difference between the placebo and NADH groups.

Even so, the results were good enough for Menuco, which says it had about $20 million in retail sales of NADH, its only product, last year. The words "clinically proven relief for jet lag" have already crept into its pitch.