Whichever way doctors or parents view the new recommendations, the studies and information that prompted the policy overhaul draw concern across the board.
Dr. Janet Silverstein, professor and chief of pediatric endocrinology at the University of Florida in Gainesville, Fla., was a member of the AAP council on nutrition that issued the new guidelines.
Since 2000, studies spanning 20 years and large autopsy studies on thousands of soldiers and children all pointed to the idea that childhood cholesterol problems can determine heart problems in middle age, Silverstein said.
"At a very young age the [autopsied children] had fatty streaks in their arteries," said Silverstein. "At the age of 8, I believe, they already had raised plaques in their arteries."
But what really alarmed Silverstein were long-term studies that showed heart disease developed over a lifetime. "We learned that even if, at the age 25, they decided to change their ways and lead the perfect life -- cardiac events were predicted by their health in adolescence," she said.
Although the AAP cites such dark studies in its policy statement, neither the AAP nor the supporters of the guidelines downplay lifestyle choices. Folded into the AAP policy are diet guidelines to feed infants and toddlers reduced-fat milk.
The AAP also recommends weight management as the primary treatment for overweight children with high triglyceride levels or low levels of HDL cholesterol.
"We do know that lifestyle plays just as an important role as genetics for heart disease," says Dr. Tanya Remer Altmann, a pediatrician in Westlake Village, Calif., who worked with the national dairy council and with the AAP on the guidelines.
"It's never too early to have a healthy lifestyle," she said.