The startling recommendation by the American Academy of Pediatrics to put young children on cholesterol-controlling medicine has provoked a reaction from physicians questioning the risks of resorting to drug treatment in the absence of adequate safety data when less risky alternatives are available.

Reacting to the nation's childhood obesity epidemic with concerns about heart disease when they become adults, the academy issued new guidelines that call for children as young as 8 to be given cholesterol-fighting drugs if they have too much "bad" cholesterol in combination with other conditions such as obesity, high blood pressure and family history. The academy also recommended that screening begin at 2 and no later than age 10 where family histories warrant it to guard against heart disease as adults.

But some pediatricians object that does not justify such aggressive drug therapy in the absence of studies and data to assess risks and benefits.

"What are the data that show this is helpful in preventing heart attacks?" asked Dr. Darshak Sanghavi, pediatric cardiologist and assistant professor at the University of Massachusetts Medical School. "How many heart attacks do we hope to prevent his way? There's no data regarding that."

"We're talking about potentially treating thousands and thousands of children simply to possibly prevent one heart attack," Dr. Sanghavi said in a New York Times article reporting reaction to the recommendation.

Joining Dr. Sanghavi was Dr. Lawrence Rosen, vice chairman of an academy panel on traditional and alternative medicine. "I'm embarrassed for the A.A.P.," he said. "Treatment with medications in the absence of any clear data? I hope they're ready for the public backlash."

Academy officials admitted they have no data on the long-term use of statins in children and relied on available information for adults.

The rush to drug therapy over other treatments is an issue with Dr. David Ludwig, director of the childhood obesity program at Children's Hospital in Boston.

"My concern is what this is saying about society when we are so quick to prescribe drugs for these conditions before having systematically attacked the problem from the public health perspective," he said.

Before resorting to powerful medications, physicians with the rest of the society have to strongly encourage lifestyle changes. Rather than instill in children a sense of dependency on drugs at an early age, they need to be taught healthy living habits that will continue well beyond childhood into adulthood, and, who knows, even prevent the need for medication later in life as well.