Adam Perlman, MD, MPH, executive director, Institute for Complementary and Alternative Medicine; UMDNJ Endowed Professor of Complementary and Alternative Medicine; assistant professor, medicine,UMDNJ-School of Health Related Professions

The Institute for Complementary and Alternative Medicine (ICAM) was created as a University-wide initiative housed within the School of Health Related Professions. Although the Institute has, as part of its mission, clinical, educational and research agendas related to complementary and alternative medicine, I have focused primarily on the research component. Currently, I have four funded projects underway.

The largest active study is investigating whether taking daily vitamins affects the academic and behavioral performance of children in third through sixth grades. This study, which will continue through June 2005, is funded by a $400,000 grant received from The Healthy Foundation’s Better Student Research Initiative.

The 700 students participating in the double-blind, randomized study are enrolled in 37 parochial schools in Newark, Jersey City, Elizabeth, East Orange, Orange, Irvington, Paterson and Passaic. Half of the students receive a free multivitamin-mineral supplement every day in school and the other half receive a placebo.

At the end of the school year, we will evaluate each student’s standardized test scores, grade point averages, tardiness, absenteeism and behavioral issues. Height and weight data for each child will be collected. In a subset of children, we are also obtaining a food frequency dietary recall with the hope that this will lead to further research and development of programs to address the increasing problem of childhood obesity and poor diet. All students participating in the study will receive free vitamins for one year after the study ends.

Co-investigators for the initiative are John Worobey, PhD, and Daniel Hoffman, PhD, from the Department of Nutritional Sciences at Rutgers; Jeffrey Smith, PhD, of the Department of Educational Psychology at Rutgers; Julie O’Sullivan Maillet, PhD, associate dean at the UMDNJ-School of Health Related Professions (SHRP); and Riva Touger-Decker, PhD, program director of the Graduate Clinical Nutrition program at SHRP.

The multivitamins and placebos for this study were donated by officials at Tishcon Corporation in Maryland. United States Pharmacopia performed testing of the vitamins for purity and content.

Our other projects include a study of the efficacy of massage therapy for osteoarthritis of the knee, a survey of patients at The Cancer Institute of New Jersey about their use of complementary and alternative medicine, and a study on the use of point-of-sale technology to provide consumers with dietary supplement-drug interaction information at the check-out counter.

This last project is funded by the National Institutes of Health through the Small Business Innovation Research (SBIR) mechanism. ICAM has teamed up with Innovative Health Information, Inc., and ShopRite to determine if providing consumers with dietary supplement-drug interaction information printed directly on the receipt when they purchase supplements will help them avoid potential interactions. The federal government has estimated that there are more than 250,000 potential drug-herb interactions per year in the U.S. In 2002, the CDC determined that 19 percent of adults had used natural products, including herbs and dietary supplements, during the previous 12 months. Currently, there is no reliable way of providing consumers with timely information on dietary supplements.

The proposed system, referred to as the Buyer Information Network or BuyIN, integrates existing point-of-sale and bar code technology with the Internet and a relational database. A basic scenario of use is as follows: A customer brings items to the cashier for check-out. One of the products purchased by the customer, for example, St. John’s wort, has potential risks for drug-dietary supplement interactions. When the cashier scans the bar code number for St. John’s wort, (a) the product ID is matched to an address for targeted items on the BuyIN server; (b) a health warning message is downloaded to the cash register terminal (either from a remote server, regularly updated local server, or CD source); (c) the message is printed directly on the bottom of the receipt; and (d) the cashier rips the receipt along a perforation and hands the health warning message directly to the consumer. Some of the attributes of BuyIN worth mentioning include: (a) information in the system has high validity (i.e., is based on the best and most recent research available and the entity responsible for maintaining the database has high credibility); (b) the information is comprehensive to the extent possible (i.e., includes all available products of major manufacturers and adds new products to the system as they become available to the public); (c) it is built around a “smart” database, which permits easy and rapid updating of information and flexible management of information; (d) it is easily scalable to accommodate large numbers of transactions; and (e) it is continually evaluated to improve the effectiveness of the system in lowering the incidence of negative drug-dietary supplement interactions.

Complementary and alternative medicine (CAM) has been described as a group of diverse medical and healthcare systems, therapies and products that are not presently considered to be part of conventional medicine. CAM is utilized primarily as an adjunct to conventional healthcare by an increasing number of the U.S. population. In a study conducted by David Eisenberg at Harvard in 1997, it was found that approximately 42 percent of the U.S. population had used some form of CAM in the previous 12 months, and it was estimated that $47 billion was spent on CAM therapies in 1997. Recent data collected by the Centers for Disease Control and Prevention found that in 2002 approximately 62 percent of U.S. adults had used some form of CAM in the prior 12 months. The realization of this increased utilization of CAM by the U.S. population has created a need for more critical appraisal of the various CAM modalities and practices available.

Adam Perlman, MD, MPH, received his BA from Tufts University and his MD from Boston University School of Medicine. He completed residencies in both internal medicine and preventive medicine at Boston Medical Center. Dr. Perlman completed a general medicine research fellowship and a Master’s of Public Health with a concentration in biostatistics and epidemiology at the Boston University School of Public Health. He is executive director of ICAM and is also an assistant professor of medicine at SHRP. Dr. Perlman was named the UMDNJ Endowed Professor of Complementary and Alternative Medicine in 2004. §