Interviewing an Omega-3 Legend – Dr. Jorn Dyerberg
OmegaMatters: Episode 8, Part 1
Hosts: Drs. Bill Harris & Kristina Harris Jackson
Guest: Dr. Jörn Dyerberg
Background and key takeaways:
Dr. Bill Harris and his daughter, Dr. Kristina Harris Jackson, are joined by Dr. Jörn Dyerberg. In part 1 of this two-part series, Dr. Dyerberg chronicles the rise of omega-3s EPA and DHA, including their discovery, early research findings, and how they were catapulted into the spotlight as a result of his research on the Greenland Inuit.
Dr. Jörn Dyerberg:
Dr. Jörn Dyerberg is a pioneer in the omega-3 fatty acid world, having made the discovery of their important heart health benefits more than four decades ago while researching the native Greenland Inuit. Along with his colleague, Dr. Hans Olaf Bang, the two embarked on an adventure that started in the late 1960s and trickled well into the 1970s. It started with their curiosity about the Inuit’s high fat diet and their very low incidence of heart disease. Their goal was to examine their blood and their diet. At the time, the Inuit subsisted mainly on a diet of high-fat seal and fish, however, the rates of heart disease were staggeringly low compared to Americans eating a much different diet but had much high rates of heart disease. Their first publication appeared in the Lancet in 1971. What this research showed is that the Inuit actually had favorable lipid levels despite their high-fat diet. It was in a subsequent publication in 1975 in the American Journal of Clinical Nutrition that they detailed the specific omega-3s eicosapentaenoic acid (EPA) and docosahexaenoic (DHA). This led to several landmark publications during the following decades and a stream of interest in these newly discovered molecules.
Dr. Bill Harris: Welcome everyone. This is Bill Harris, here with Kristina Jackson, for another episode of our series called “Omega Matters,” where we talked about all things Omega. Pretty much Omega-3, and one of these days we may talk about Omega-6 if we have enough courage to do that.
Dr. Bill Harris: It is a privilege today to have with us the founder of the omega-3 story, Dr. Jörn Dyerberg from Copenhagen. Welcome, Jörn. Good to see you.
Dr. Jörn Dyerberg: Good to see you.
Dr. Bill Harris: We’ve been, of course, friends for many years, crossed paths probably in the 1990s somewhere. Or maybe in the 1980s.
Dr. Jörn Dyerberg: I think it was the 1980s in Seattle.
Dr. Bill Harris: Yeah.
Dr. Bill Harris: You got into this about 10 years before I did. About 10 years before anybody did, really.
Dr. Bill Harris: So, just by way of introduction, Dr. Dyerberg, along with his mentor, Dr. Hans Olaf Bang, were the pioneers who went to Greenland and studied the question of why there’s so little heart disease in native Greenland Inuit. Ultimately, this led to the discovery of the Omega-3 story. And it’s grown phenomenal legs since then. All over the world.
Dr. Bill Harris: We don’t have time for the whole story, but I would like to talk about the first paper you published in 1971. You started thinking about this in the late 1960s…
Dr. Jörn Dyerberg: I believe we were just introduced to the concept of our co-citizens in Greenland. The Danish co-citizens. Because Greenland was calmer than Denmark at that time. Now it’s a sort of a commonwealth association.
Dr. Jörn Dyerberg: At that time, the Eskimo was a word, that we used all the time. Today this word has felt maybe a bit awkward? I can’t tell why. It means, as I’m told, ‘the people who live from raw meat’. But okay, that’s a fair description… To me, that is not anything negative. But, nevertheless, there was an obligation for Danish science to illustrate or find out why the disease pattern in our co-citizens in Greenland, the Eskimos (Inuit), was different from Danes. It turned out there were some astonishing differences. There are very low incidents of coronary heart disease, which was nearly never described.
Dr. Jörn Dyerberg: At the time, I was a resident doing my thesis and making a new method for quantifying my approaches. And I was connected with Dr. Bang who arranged this research trip to Greenland.
Dr. Jörn Dyerberg: Yes, of course, thinking I’m going to Greenland, riding dogsleds. What an adventure. I was 31, or 32, or something and thought that could be gorgeous. So, we managed to collect $6000 or $8000, or something like that, which enabled us to live there for two months. Well, we managed to get up there and collect a lot from 130 Eskimos in these fasting states. And we posted the paper in The Lancet showing the lipid values. You know, the working values.
Dr. Jörn Dyerberg: They had no cholesterol. Total cholesterol. And at that time, in 1968, 1970, the only thing we knew of as a risk factor for coronary heart disease was not in tobacco smoking. It was cholesterol. The only thing that people were discussing was cholesterol. And we found a lower cholesterol than the Danes, but not to an amount that could describe the difference. So, we are left with an enigma. We also found there were no triglycerides, but no one had ever described any risk between, or had made the connection between triglycerides and heart disease. It came 30 years later, or something.
Dr. Jörn Dyerberg: Formally, we couldn’t describe the difference in cholesterol with a major difference. We can maybe return to that later on, in our discussion, in coronary heart disease. And then we did a lot of other things. And Dr. Bang had an old guess from out of the West on which we could do fatty acids, one or two a day, or something. And we decided, just for the sake of it we had 130 samples from fasting Eskimos, and no one would ever get that.
Dr. Jörn Dyerberg: So, Dr. Bang said, “We’ll just make our guesses and publish it. Someday, someone will find an interest.” And we spent two years, or something, (laughs), doing gas chromatography. And then we found two fatty acids we’d never seen before.
Dr. Jörn Dyerberg: And then I went to America with our chromatograph and lipid analysis from the Inuit and they said, “Jörn, these are the free fatty acids,” and I said “okay,” and the said “and their names are eicosapentaenoic acid, and docosahexaenoic acid.” And the only thing I said was “Say it again.” I never heard of them before.
Dr. Jörn Dyerberg: Then we came home and we published the paper in the American Journal of Clinical Nutrition. And at the same time, it came out that in Sweden they found out. There was a new prostaglandin coming from arachidonic acid that promoted prostaglandin aggregation. Thrombocyte aggregation. And then came Dr. Bang, saying, “We found a new Process that inhibits platelet aggregation.” And thereby, there’s a balance in thrombocytic generation, by generating pro-aggregatory and anti-aggregatory.
Dr. Bill Harris: So, it was the theory of arthrosclerosis, in those days, that it was a thrombotic disease?
Dr. Jörn Dyerberg: There was of course the thrombotic issue, but we never discussed that going into this. And then we got the idea… What if there was another balance? And… If it was from Omega-3, I could step in and say, “No, guys, the only fatty acid is the number 3 fatty…” We thought it was, at that time. And the strange thing is, that now, 50 years later, it’s in a way, coming up again. New studies have ignited the EPA story again.
Dr. Jörn Dyerberg: But then I shoot to London to join a meeting. And I was sitting in a small hotel room, and I decided to call Dr. Wayne and he said he had five minutes. Okay, I said. And I started, to talk about the findings… Half an hour later, and he said, “ Jörn , where are you sitting?” I said, “I’m sitting in a hotel in Central London.” And he said, “We’ll send a car down for you.”
Dr. Bill Harris: Really?
Dr. Jörn Dyerberg: And then, I stayed the month or two in his lab. Afterwards, we found out that PGI3 actually could be generated. And we published it in The Lancet.
Dr. Jörn Dyerberg: And then, we used that to ignite this story about, you know, these free fatty acids.
Dr. Bill Harris: Right, right. And it was all… EPA, right? DHA was not part of the program.
Dr. Jörn Dyerberg: No. This was a long fellowship living up there and we didn’t even know it was rich in our brains, and… How should we know? Nobody had published it. Maybe there was some remote paper, but nobody knew a thing about any of these fatty acids.
Dr. Bill Harris: Interesting. Yeah, interesting.
Dr. Bill Harris: Had you been doing fatty acid research? I mean, you had, I guess, chromatograph in your lab.
Dr. Jörn Dyerberg: Fifteen years earlier there was this story on Dr. Orwen, from Norway, telling people that linolenic acid was good for your health. And he published that in The Lancet. He was a very famous Norwegian scientist. And it actually came out that the data was not that good. But his assistant cooked the data a bit because she was sad about the bad results. So, his paper, that was, while was famous in The Lancet, had to be retracted because there wasn’t any association between linolenic acid and coronary heart disease.
Dr. Jörn Dyerberg: So, he had to retract that paper. But at that time, when it was drawn up, Dr. Bang had bought a gas chromatic lab. So it was there at his lab. It hadn’t been working for years, and we re-fused it. And we made it work.
Dr. Jörn Dyerberg: That made us make fatty acids — finding the EPA and the DHA — and writing a paper together with Dr. Bang, and Salvador Moncada, on EPA and its protection against thrombosis.
Dr. Bill Harris: You were just there at the right time, with the right observations, weren’t you? You didn’t really do the epidemiology in Greenland. Others had done that.
Dr. Jörn Dyerberg: Yes, there were other papers. And later, when we wrote about it, there were also comments in our paper… Yes, we have been doctors here for 30 years, I’ve never seen a coronary heart attack. And so on, and so on. But this wasn’t solid data.
Dr. Jörn Dyerberg: Then we wrote the paper together, with epidemiologist, Dr. Pianko, in International Journal of Epidemiology.
Dr. Jörn Dyerberg: And I, I just was looking for it, and I, and I found it here. It’s a mortality from heart disease in Greenland. International Journal of Epidemiology from 1988. Where we’ve, again, demonstrated, based on this data, that there was a low incidence of coronary heart disease in that population.
Dr. Bill Harris: Was that data calling into question the last 10 years, or something?
Dr. Jörn Dyerberg: No.
Dr. Bill Harris: Didn’t somebody write a paper saying- “Where is the evidence?”
Dr. Jörn Dyerberg: What is the evidence. That was a Canadian group that wrote that some years ago, and said, well, I had never gotten any epidemiology studies. And I wrote back, “What do you call this, then?”
Dr. Jörn Dyerberg: Uh, indicating that they hadn’t read it. (laughs) Because he wasn’t an epidemiologist, either.
Dr. Bill Harris: Oh, okay.
Dr. Jörn Dyerberg: (laughs)
Dr. Bill Harris: Is there a difference between Inuit in Canada and the Inuit in Greenland?
Dr. Jörn Dyerberg: There was some tendency and stuff. But it was never substantiated in Canada. And, again, now there’s a new paper saying that we can’t find any, major difference…
Dr. Bill Harris: Right. That was published, like, in 2020.
Dr. Bill Harris: Has the Inuit diet changed, over the years?
Dr. Jörn Dyerberg: Yeah, I was looking at the data. They don’t find anything, to be honest. But the strange thing is they don’t find it in an area of intake between .75 and 2 grams per day. Which is, to me, rather narrow.
Dr. Jörn Dyerberg: I mean, it wasn’t like… The thing we saw, when we were up there. We didn’t see any down, on the highest rates, 2 or something, but it was different days.
Dr. Jörn Dyerberg: But their Omega-3 Index, on the other hand, between 4% and 11%.
Dr. Bill Harris: What was the EPA, DHA intake, or… EPA intake, in your Eskimos? When you calculated.
Dr. Jörn Dyerberg: It was approximately 20 grams, per day.
Dr. Bill Harris: 20?!
Dr. Jörn Dyerberg: 20, yeah.
Dr. Bill Harris: Wow. And was that, like, all year round? Or was that just… Seasonal?
Dr. Jörn Dyerberg: The food was the same there, at that time, all year round. It was based on seal, and fish, and then once in a while a whale. But rarely.
Dr. Jörn Dyerberg: And then there was delivery of Western food, in form of grain, and sugar together.
Dr. Bill Harris: Wow.
Dr. Jörn Dyerberg: Together. And alcohol. Yeah. Which is a major issue. A major issue.
Dr. Jörn Dyerberg: But at that time, it was basically the old Inuit diet.
Dr. Bill Harris: Yeah, okay.
Dr. Jörn Dyerberg: You know, we had to go a further 100 years back, I guess, or so.
Dr. Bill Harris: Is there anything special about seal oil, compared to fish oil?
Dr. Jörn Dyerberg: Yeah. There’s been a lot of talking about whether this has any meaning. And there is no difference. What does seal eat? Fish. Where are the fatty acids there?
Dr. Jörn Dyerberg: So that’s the story of my life. It’s over now.
Dr. Bill Harris: Yeah, it’s not over now. It’s just…
Dr. Jörn Dyerberg: No, I’m just sitting and enjoying the rest of it. (laughs)
Dr. Bill Harris: Well, let’s plan on coming back, because I want you to kind of walk through the last 40 years and look at the highs and the lows of the whole Omega-3 story. Not just atherosclerosis, but when it got to the brain, when it got to human development, and when it got into all these other diseases. Because it’s been quite a rollercoaster.
Dr. Jörn Dyerberg: Yeah. A little bit of a rollercoaster.
Dr. Bill Harris: Plus, you even got out of Omega-3 and got into trans for quite a while, too.
Dr. Jörn Dyerberg Yeah, I had a professorship in human nutrition and through that we were focused very much on fat. And then came the trans story. We played a role in merging or shifting the concept towards an anti-industrial trans fatty acids.
Dr. Jörn Dyerberg: It has all been a rollercoaster. Studies on omega-3s were not that positive and then today is a different story. Why is the situation wishy-washy? There’s no discussion — when you look at the association between high seafood eaters, and low seafood eaters, there’s a difference. But the studies are not that overwhelmingly positive.
Dr. Bill Harris: Yeah, it’s certainly not a silver bullet, but it is something people can do to reduce risk.
Dr. Jörn Dyerberg: Sure.
Dr. Bill Harris: Yeah. So we’ll get back to that. I think, I think at this point we better wrap it up. And we will, get back with you, with some more questions for Part 2 of this episode.
Dr. Bill Harris: Thank you very much for joining us. Appreciate it.
Dr. Jörn Dyerberg: Good to see you. Yeah. Bye-bye.
Dr. Bill Harris: Yeah. Bye-bye.
Dr. Kristina Harris Jackson: Thank you.