Between the ages of 20 and 50 years, there is a gradual rise in serum cholesterol concentrations. In the USA, for example, the serum cholesterol increases on average about 50mgdl~1 (1.295mmoll-1). This change may be related in part to increasing obesity, according to the mechanisms described above. However, even in people who do not gain weight with advancing age, serum cholesterol concentrations usually rise to some extent. Available evidence indicates that this rise results from a decrease in expression of LDL receptors. The reasons for a decline in receptor synthesis with aging are not known, but may reflect 'metabolic' aging. However, in men, after age 50 years, there is little further rise in serum cholesterol. This observation suggests that the impact of weight gain, which occurs mostly between the ages of 20 and 50 years, may be greater than generally recognized.

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