Statins used to be for aging boomers and their parents. Now the American Academy of Pediatrics says the cholesterol-lowering drugs can help kids as young as 8 who suffer from extremely high cholesterol levels. (The FDA has approved most statins for kids as young as 10, and pravastatin for those as young as 8.) Doctors stress that these guidelines do not mean that all obese kids should take statins.

In a recent clinical report in the journal Pediatrics, Dr. Stephen Daniels, pediatrician in chief at the Children’s Hospital in Denver, said kids between the ages of 2 and 10 with a family history of early heart disease or those with an unknown family history or other cardiovascular-disease risk factors, such as obesity or diabetes, should be screened with a fasting lipid profile. For overweight kids with a high triglyceride concentration or a low HDL (good) cholesterol concentration, weight management is the main treatment. For overweight kids with an LDL (bad) cholesterol reading of 190 or greater, even after trying diet and exercise, doctors should consider medications. The side effects of statins: mainly the elevation of liver enzymes and muscle inflammation. But Daniels says fewer than 1 percent of adolescents get a meaningful side effect that makes them want to stop taking the drugs. Dr. Frank Greer, chair of the AAP’s committee on nutrition, says, “If your father had a heart attack at age 27, and you have the same lipid profile as your dad, what’s the greater risk?”

Still, some doctors question the benefits of starting so young, especially when the risks are largely unknown. While statins may lower cholesterol levels, they don’t necessarily reduce kids’ risk of heart disease later. Doctors say it’s most important for kids to control weight through diet and exercise, though diet typically reduces cholesterol levels by only 15 or less. “Some kids have levels that are high enough that you’re still left with cholesterol that’s higher than you would like,” says Daniels. No amount of oatmeal, leafy greens and soccer practice will change that.