Eating fish on a regular basis was linked with substantially lower levels of inflammation in the body, according to the largest study yet to find such a benefit.

The study also found that the fish could be small, lean varieties and did not have to be fatty, cold-water species such as salmon, which contain the highest amounts of omega-fatty acids.

"It's beginning to build a very strong case for increasing fish intake to reduce cardiovascular risk," said Robert Wilson, a professor of medicine at the University of Minnesota Medical School, who was not a part of the study.

The study, which involved more than 3,000 Greek men and women with an average age of about 45, used blood samples to measure levels of a variety of substances such as C-reactive protein that indicate the level of inflammation in the body. .

It found that those who ate at least 10.5 ounces of fish a week generally had as much as 33% lower levels of the various inflammatory substances, compared with those who did not eat fish. Those who ate between 5.3 and 10.5 ounces a week also had less inflammation than those who did not eat fish.

C-reactive protein and other markers of inflammation have been associated with heart disease, heart attacks and stroke. The substances are believed to play an important role in the buildup of unstable plaques inside blood vessels.

In addition to a drop of 33% in C-reactive protein, the regular fish-eaters also had lower leveIs of other inflammatory substances, including 33% less interleukin-6; 21% less tumor necrosis factor-alpha; 28% less serum amyloid A; and 4% lower white blood cell counts.

The study, which was published recently in the Journal of the American College of Cardiology, also looked at levels of omega-3 fats and determined that the optimal level for reducing inflammation was 0.6 grams a day, the amount that might be found in one or two fish oil capsules or the amount found in just under 2 ounces in a mixed variety of fish.

In an e-mail, co-au thors Antonis Zampelas and Demosthenes Panagiotakos - both from
Harokopio University in Harokopio University in Athens' speculated that consuming omega- 3 fatty acids in the form of supplements, such as fish oil capsules, also can reduce inflammation.

Though many of the people in the study ate fried fish, Pimagiotakos said it probably is best to eat baked fish.

"Frying is notthe best way to eat fish," he said. "However, in Greece a lot of households use olive oil to fry fish."

He noted that olive oil is high in monounsaturated fat, which is considered healthy.

Still, frying adds more calories, and the process of frying can add trans fatty acids that are bad for the heart, he said.

The new study also suggests that you don't need to eat salmon or other fatty fish and that you don't need to eat a lot of fish to get a benefit, said Wilson, a cardiologist at the University of Minnesota.

"Probably two (4 - to 5 ounce) portions a week is going to make an impact," Wilson said. That probably could come from the type of fish caught in freshwater lakes in Wisconsin, he added.

One issue the study did not resolve is whether it is the fish or the omega-3 fats that provide the biggest health benefit, said Eric Rimm, an associate professor of epicdemiology and nutrition at the Harvard School of Public Health.

And it is possible that it could be neither, he said. For instance, it could be that people
who eat a lot of fish eat less of other inflammation-producing foods, such as red meat, although the study tried to correct for that, Rimm said.

Rimm noted that many other studies have suggested that the primary benefit from fish
is the prevention of dangerous arrhythmias.

The new study add's to the growing amount of research suggesting that fish have anti-inflammatory properties that might prevent heart attacks, he said.

"This suggests there may be an additional ,mechanism," Rimm said. "It adds alittle piece
to the puzzle.

Noting that numerous studies have shown a link between eating fish and heart health, the American Heart Association recommends eating fish twice a week. However, it warns that certain fish may contain high levels of environmental contaminants such as mercury and polychlorinated biphenyls.

In general, those contaminants are higher in older, larger, predatory fish.

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