Childhood obesity rates in the US are high
Many more obese children, including some as young as eight, should receive cholesterol-lowering drugs, say leading US doctors.
Children in the UK with a rare gene fault can get statins, but the American Academy of Pediatrics is going further.
It wants to see the drugs used in thousands more children with high cholesterol levels, despite little information about long-term safety.
A UK specialist said he did not support widespread statin use for children.
High cholesterol levels in childhood are thought to be a possible factor in the development of heart disease later in life.
Approximately one in 500 children carries the "familial hypercholesterolaemia" gene, which gives them a 50% chance of heart disease, often early in life, and two types of statin are already licensed for use in the UK in these children.
The National Institute for Health and Clinical Excellence is expected to back this type of treatment in guidance due out next month.
The American Academy of Pediatrics, however, believes that the drugs, which are used by millions of adults worldwide, could benefit thousands more children who are already obese, or showing signs of high blood pressure or type II diabetes.
It wants all children with these problems, or with a family history of heart disease, to be screened for high cholesterol, and statins considered for those with particularly high levels from age eight onwards.
The recommendation has proved controversial in the US, with some doctors concerned that pills were no substitute for a better diet and more exercise.
In the UK, one specialist who recommends the use of statins in children carrying the gene said he would not support any extension of that policy.
Professor Andrew Neil, from the University of Oxford, said that while the safety of statins in adults was "well established", there was far less information about this in children, who might expect to use them for very long periods.
He said: "While I fully support the use of statins in children with familial hypercholesterolaemia, it is not my view that they should be used in the myriad of children with simple obesity or moderately elevated cholesterol."
A spokesman for the British Heart Foundation said that no-one, child or adult, should be relying entirely on statins to improve their health, in the absence of improved diet and more exercise.