Part a Reading Task Diseases of Affluence

Reading Part A

Diseases of Affluence 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 blood pressure and (3)____. Yet the causes of these conditions are things often

3. 4. 5.

regarded as (4) ____ in their lifestyles. For example, the ability to afford a car can lead to reduced

6.

(5)____. This combined with higher consumption of (6)____and (7)___ products, grains and white bread can have negative health consequences. Foods in affluent countries are also high in (8)___ and

7. 8.

(9)___and commercially processed.

9.

A 2005 study by (10)____ analysed data from over

10.

(11)____. According to their findings, (12)____and cholesterol rose markedly before leveling off and finally (13)____in relation to national income. Whereas the economic factors did not (14)____the average population blood pressure.

11. 12. 13. 14.

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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 while countries are experiencing (16)____ and (17)____. Methods to reduce obesity include reducing (18)____ and focussing on (19)___ to ensure that there is (20)____for outside activities.

17. 18. 19.

Cigarette smoking is also a significant health

20.

concern for the developing world with approximately (21)____ of the worlds (22)____ smokers from developing nations. Based on patterns of the industrialised world, the number of male smokers will (23)____ while the number of female smokers is

21. 22. 23.

likely to (24)____. However, future tobacco consumption patterns may not associate directly with

24.

(25)____, as efforts to control its use become widespread. In summary, cardiovascular disease risks are likely to transfer to (26)____ income countries which when

25. 26. 27.

combined with the current problem of (27)____, will lead to further inequalities in (28)____. Therefore prevention of (29)____ as well as education in the areas of blood pressure and cholesterol must be a (30)____ for developing nations.

28. 29. 30. TOTAL SCORE

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Reading Part A

Part A Time Limit: 15 minutes Instructions • Complete the summary on the answer page using the information in the four texts below. • Skim and scan the texts to find the information required. • Write your answers in the appropriate space in the column on the right hand side. • Make sure your spelling is correct. Diseases of 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 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 for outdoor activities.

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Reading Part A

Text 3 Source: Public Library of Open Science Current Research

Authors: Ezzati, M et al 2005

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 these illnesses 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 -Higher consumption of meat and dairy products -Higher consumption 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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Reading Part A

Diseases of Affluence Answer Sheet 1. affluence 2. economic development 3. cholesterol 4. improvements 5. physical exercise 6. meat 7. dairy 8. fat 9. sugar 10. Ezatti, M/Ezatti 11. 100 countries 12. BMI 13. Declining (requires word form change to gerund) 14. Significantly affect (requires change of verb to active form) 15. obesity 16. economic growth 17. urbanisation 18. calorie intake 19. urban design 20. space 21. 930 million 22. 1.1 billion 23. reduce (verb form of reduction)/decline 24. increase/rise 25. national income 26. low and middle (all 3 words required) 27. infectious diseases 28. global health 29. obesity 30. priority

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Reading Part A

Highlighted Answers 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 (22)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 (23)reduction/reduce in the number of male smokers and an (24)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 (25)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 (16)economic growth and (17)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 (18)calorie intake and increasing energy expenditure of a population through (19)urban design which incorporates (20)space for outdoor activities.

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Reading Part A

Text 3 Source: Public Library of Open Science 2005

Authors: (10)Ezzati, M et al

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/declining. 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 (14)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 (26)low and middle income countries and, together with the persistent burden of (27)infectious diseases, further increase (28)global health inequalities. Preventing (29)obesity should be a (30)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 increase of these illnesses appear to be, paradoxically, things which many people would regard as lifestyle (4)improvements. They include: -Less strenuous (5)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 (8)fat and high (9)sugar foods in the diet are common in the affluent developed economies -Higher consumption of (6)meat and (7)dairy products -Higher consumption 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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