Fish oil may not be much of a heart-saver for those who've already had a heart attack

LOS ANGELES — Fish oil has long been touted as one of nature's heart-helping natural compounds, but is it worth popping that jellied pill as part of your nutrition regime?

Might depend on who you are.

A Dutch study found that people who had already suffered heart attacks did not significantly reduce their risk of heart attack, stroke, heart failure and other cardiovascular events by eating about 400 mg of fish fatty acids per day. But the supplement did help those patients who had diabetes in addition to a past heart attack.

The findings, published Saturday in the New England Journal of Medicine, also found that women who consumed alpha-linolenic acid (found in soybean and linseed oil, among others) showed fewer major cardiovascular events.

Many studies that have described benefits from fish oil have given participants unreasonably high doses, sometimes 1 to 2 grams of marine fatty acids, said Daan Kromhout, the study's lead author, in a phone interview. (He's a nutritional epidemiologist at Wageningen University in the Netherlands.) That's a lot, he added. His team decided to test a dose of 400 milligrams of fish oil — the equivalent of two fatty fish meals a day.

Kromhout and colleagues suspect that the reason they saw little effect was because the test population — between 60 and 80, and mostly men — were already being heavily medicated for their health issues: About 98 percent were on anti-platelet treatments, 90 percent were taking blood pressure lowering agents and 85 percent were taking lipid-lowering agents.

The fact that the researchers saw a significant drop in cardiovascular issues in people who were also suffering from diabetes supported the notion that the less healthy patients are, the more noticeable the effects of fish oil would be.

In any case, Kromhout added, don't stop eating fish. It's probably still good for prevention purposes. And, he added, those looking for the benefits should skip the see-through capsules and go for the whole salmon.

"Fish are a rich source of vitamin D, and more evidence is coming out that vitamin D could also be of benefit in relation to cardiovascular disease," Kromhout said. "There are many more good things in fish than in fish oil capsules."