Expert panels recommend reduction of dietary fat and cholesterol, because excessive fat intake may lead to known health hazards. However, there are no data demonstrating beneficial effects of such diets starting in childhood for all children, including those with normal serum cholesterol levels. Dietary restrictions in early life may not necessarily induce a long-lasting decrease in blood cholesterol levels in children persisting into adulthood or reduce disease incidence. On the other hand, the result of such diets may be suboptimal growth and development. Furthermore, low fat diets may lower high density lipoprotein cholesterol levels and not specifically low density lipoprotein cholesterol. In addition, low serum cholesterol levels may be associated with increased mortality, including deaths due to accidents, which is most important in children. Recently, increased attention has been drawn to the association between short stature and/or nutritional status and deficiencies in intrauterine and early life with coronary artery disease in adulthood. Also, the problems of associated psychological consequences, family conflicts and cost should not be ignored while implementing a low fat diet. In this review, we discuss the controversies on dietary fat restrictions for children.