1

Reading Part A

Reading: Part A - Answer Booklet

Part A Summary Gap Fill Time Limit: 15 minutes
Instructions
• Complete the following summary using the information in the texts
for this task.
• Skim and scan the texts to find the information required.
• Gaps may require 1, 2 or 3 words.
• Write your answers in the appropriate space in the column on the
right hand side.
• Make sure your spelling is correct.
Summary Answers
1.
Diseases of ....(1).... is a term used to describe a range
of risk factors associated with cardiovascular disease 2.
which increase along with a country’s or society’s
....(2).... . These risk factors include obesity, high 3.

blood pressure and ....(3).... .

4.

It is clear that as people become more affluent, the 5.

risk of cardiovascular diseases ....(4).... . For example,
the ability to afford a car can lead to reduced ....(5).... 6.
In addition, society has access to large quantities of
7.
food which is not ....(6).... . This combined with
....(7).... consumption of high fat and high sugar
8.
products can have negative health consequences.
Processed grains and white bread have also become 9.
more....(8).... and there is a wider ....(9).... of meat
and dairy products. 10.

11.
A 2005 study by ....(10).... et al analysed data from
more than ....(11).... According to their findings,
12.
....(12).... and cholesterol rose markedly before
leveling off and finally ....(13).... in relation to 13.
national income. Whereas the economic factors did
not have a significant ....(14).... on the average blood 14.
pressure of the population.

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Reading Part A

Part A Answer Sheet continued

Summary Answers
15.

Based on this information, preventing ....(15).... 16.

should be a priority in countries where the economy
is ....(16).... and their societies are becoming more 17.

urbanised. Methods to reduce obesity include

18.
....(17).... calorie intake and focussing on improved
....(18).... to ensure that there is enough ....(19).... for 19.
outside activities.
20.

21.
Cigarette smoking is also a significant health
concern for the developing world with ....(20).... of
22.
the world’s cigarette smokers from developing
nations. Based on patterns of the ....(21).... world, the 23.
number of male smokers will ....(22).... while the
number of female smokers is likely to ....(23).... . 24.
However, future tobacco consumption patterns may
25.
not associate directly with ....(24).... as efforts to
control its use become widespread.
26.

In summary, cardiovascular disease risks are likely 27.

to transfer to ....(25).... income countries, which
when combined with the current problem of ....(26).... 28.
, will lead to further inequalities in ....(27)....
29.
Therefore prevention of ....(28).... as well as
education in the areas of blood pressure and
cholesterol must be a ....(29).... for developing
nations. TOTAL SCORE

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 3
Reading Part A

Texts
Source: Public Library of Open Science
Authors: Ezzati, M et al 2005
Text 1

Tobacco

Tobacco smoking is also an important risk factor for cardiovascular diseases.

Currently, an estimated 930 million of the world’s 1.1 billion smokers live in the
developing world. Tobacco smoking increased among men, followed by women, in
industrialized nations in the last century, and has subsequently declined in some
nations such as Canada, the United States, and the United Kingdom. Descriptive
models based on historical patterns in the industrialized world predict a reduction in
the number of male smokers and an increase in the number of female smokers in the
developing world over the coming decades. However, there have been major recent
transformations in global tobacco trade, marketing, and regulatory control. As a
result, tobacco consumption among men and women in most nations is primarily
determined by opposing industry efforts and tobacco control measures, and by the
socio-cultural context, rather than national income.

Text 2

BMI

The observed rapid BMI increase with national income indicates that preventing
obesity, which may be more effective than reacting after it has occurred, should be a
priority during economic growth and urbanization of a nation. Overweight and
obesity are also important because they cause a number of non- cardiovascular
outcomes including cancers, diabetes, and osteoarthritis which cannot be addressed by
reducing risk factors such as blood pressure and cholesterol. Current intervention
options for obesity in principle include those that reduce calorie intake and increasing
energy expenditure of a population through urban design which incorporates space
recreation and for outdoor activities.

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 4
Reading Part A

Text 3
Source: Public Library of Open Science Authors: Ezzati, M et al 2005
Current Research

Background
Cardiovascular diseases and their nutritional risk factors—including overweight and
obesity, elevated blood pressure, and cholesterol—are among the leading causes of
global mortality and morbidity, and have been predicted to rise with economic
development in countries and societies throughout the world.
Methods and Findings
We examined age-standardized mean population levels of body mass index (BMI),
systolic blood pressure, and total cholesterol in relation to national income, food share
of household expenditure, and urbanization in a cross-country analysis. Data were
from a total of over 100 countries and were obtained from systematic reviews of
published literature, and from national and international health agencies.
BMI and cholesterol increased rapidly in relation to national income, then flattened,
and eventually declined. BMI increased most rapidly until an income of about I$5,000
(international dollars) and peaked at about I$12,500 for females and I$17,000 for
males. Cholesterol’s point of inflection and peak were at higher income levels than
those of BMI (about I$8,000 and I$18,000, respectively). There was an inverse
relationship between BMI/cholesterol and the food share of household expenditure,
and a positive relationship with proportion of population in urban areas. Mean
population blood pressure was not significantly affected by the economic factors
considered.
Conclusions
When considered together with evidence on shifts in income–risk relationships within
developed countries, the results indicate that cardiovascular disease risks are expected
to systematically shift to low and middle income countries and, together with the
persistent burden of infectious diseases, further increase global health inequalities.
Preventing obesity should be a priority from early stages of economic development,
accompanied by measures to promote awareness of the causes of high blood pressure
and cholesterol.

Text 4
Health Repercussions of Western Lifestyle

Factors associated with the increase of cardiovascular disease appear to be,

paradoxically, things which many people would regard as lifestyle improvements.
They include:
-Less strenuous physical exercise, often through increased use of a car
-Easy accessibility in society to large amounts of low-cost food
-More food generally, with much less physical exertion expended to
obtain a moderate amount of food
-More high fat and high sugar foods in the diet are common in the
affluent developed economies
-Increased range of meat and dairy products
-Increased popularity of grains and white bread
-More foods which are processed, cooked, and commercially provided
(rather than seasonal, fresh foods prepared locally at time of eating)

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 5
Reading Part A

Diseases  of  Affluence:  Answer  key  and  explanation  

 
Answer   Details  
1. affluence   Type  1  
2. economic    
development   Type  1  
3. cholesterol  
Type  1  
 
4. increases   Type  2:  change    word  form:  increase  (noun  )  →  
  increases  (verb)  
5. physical  exercise  
Type  1  
 
6. expensive/high  in  
cost   Type  4:  change  word  to  match  meaning  
 
7. higher/increased  or  
words  of  similar   Type  4:  select  word  based  on  understanding  of  
meaning   meaning  
 
8. popular   Type  2:  change    word  form:  popularity  (noun  )  →  
  popular  (verb)  
9. range/variety  
Type  1    
 
 
10. Ezatti   Type  1  
 
11. 100  countries  
Type  1  
 
12. BMI  
Type  1  
 
Type  2:  change    word  form:  declined  (verb  )  →  
13. declining  
declining  (gerund)  Note,  change  word  form  to  match  
 
grammar  in  the  summary  sentence  
14. effect/impact   Type  2:  change    word  form:  affected  (verb  )  →  effect  
  (noun)  Note,  correct  spelling  required.  
15. obesity   Type  1  
16. growing   Type  2:  change    word  form:  growth  (noun  )  
  →growing(verb)  
17. reducing   Type  2:  change    word  form:  reduce(verb)  →  reducing  
  (gerund)  
18. urban  design  
Type  1  
 
19. space   Type  1  
   
20. most/the  majority   Type  3  &  4:  summarise  meaning  of  numbers  into  
or  words  of  similar   words  

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 6
Reading Part A

meaning  
 
21. industrialised  
Type  1  
 
22. reduce   Type  2:  change    word  form:  reduction(noun)  →  reduce  
  (verb)  
Type  2:  change    word  form:  increase(noun)  →  
23. increase  
increase  (verb)  
24. national  income   Type  1  
25. low  and  middle  
  Type  1  
 
26. infectious  diseases   Type  1  
27. global  health   Type  1  
28. obesity   Type  1  
29. priority  
Type  1  
 

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 7
Reading Part A

Diseases of (1)Affluence
Source: Public Library of Open Science
Authors: Ezzati, M et al 2005
Text 1

Tobacco

Tobacco smoking is also an important risk factor for cardiovascular diseases. Currently, an estimated (21)930
million of the world’s 1.1 billion smokers live in the developing world. Tobacco smoking increased among men,
followed by women, in industrialized nations in the last century, and has subsequently declined in some nations
such as Canada, the United States, and the United Kingdom. Descriptive models based on historical patterns in the
(22) industrialized world predict a (22)reduction in the number of male smokers and an (23)increase in the number
of female smokers in the developing world over the coming decades. However, there have been major recent
transformations in global tobacco trade, marketing, and regulatory control. As a result, tobacco consumption
among men and women in most nations is primarily determined by opposing industry efforts and tobacco control
measures, and by the socio-cultural context, rather than (24)national income

Text 3

BMI

The observed rapid BMI increase with national income indicates that preventing (15) obesity, which may be more
effective than reacting after it has occurred, should be a priority during economic (16) growth and urbanization of
a nation. Overweight and obesity are also important because they cause a number of non- cardiovascular
outcomes including cancers, diabetes, and osteoarthritis which cannot be addressed by reducing risk factors such
as blood pressure and cholesterol. Current intervention options for obesity in principle include those that (17)
reduce calorie intake and increasing energy expenditure of a population through (18)urban design which
incorporates (19)space for recreation and outdoor activities.

Text 3
Source: Public Library of Open Science Authors: (10)Ezzati, M et al 2005

Background
Cardiovascular diseases and their nutritional risk factors—including overweight and obesity, elevated blood
pressure, and (3)cholesterol—are among the leading causes of global mortality and morbidity, and have been
predicted to rise with (2)economic development in countries and societies throughout the world.
Methods and Findings
We examined age-standardized mean population levels of body mass index (BMI), systolic blood pressure, and total
cholesterol in relation to national income, food share of household expenditure, and urbanization in a cross-
country analysis. Data were from a total of over (11)100 countries and were obtained from systematic reviews of
published literature, and from national and international health agencies.
(12)BMI and cholesterol increased rapidly in relation to national income, then flattened, and eventually
(13)declined. BMI increased most rapidly until an income of about I$5,000 (international dollars) and peaked at
about I$12,500 for females and I$17,000 for males. Cholesterol’s point of inflection and peak were at higher
income levels than those of BMI (about I$8,000 and I$18,000, respectively). There was an inverse relationship
between BMI/cholesterol and the food share of household expenditure, and a positive relationship with proportion
of population in urban areas. Mean population blood pressure was not significantly (14) affected by the economic
factors considered.
Conclusions
When considered together with evidence on shifts in income–risk relationships within developed countries, the
results indicate that cardiovascular disease risks are expected to systematically shift to (25)low and middle income
countries and, together with the persistent burden of (26)infectious diseases, further increase (27)global health
inequalities. Preventing (28)obesity should be a (29)priority from early stages of economic development,
accompanied by measures to promote awareness of the causes of high blood pressure and cholesterol.
 
Text 4
 
Factors  associated  with  the  (4)  increase  of  cardiovascular  disease  appear  to  be,  paradoxically,  things  which  many  people  
would  regard  as  lifestyle  improvements.  They  include:  
-­‐Less  strenuous  (5)physical  exercise,  often  through  increased  use  of  a  car  
-­‐Easy  accessibility  in  society  to  large  amounts  of  (6)  low-­‐cost  food    
-­‐More  food  generally,  with  much  less  physical  exertion  expended  to    
   obtain  a  moderate  amount  of  food  
-­‐(7)More  high  fat  and  high  sugar  foods  in  the  diet  are  common  in  the  
   affluent  developed  economies  
-­‐  Increased  (9)range  of  meat  and  dairy  products  
-­‐Increased  (8)  popularity  of  processed  grains  and  white  bread  
-­‐More  foods  which  are  processed,  cooked,  and  commercially  provided    
 (rather  than  seasonal,  fresh  foods  prepared  locally  at  time  of  eating)  

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