If you head to the shops to buy bread, you’ll face a variety of different options.

But it can be hard to work out the difference between all the types on sale.

For instance, you might have a vague idea that wholemeal or wholegrain bread is healthy. But what’s the difference?

Here’s what we know and what this means for shoppers in Australia and New Zealand.

Let’s start with wholemeal bread

According to Australian and New Zealand food standards, wholemeal bread is made from flour containing all parts of the original grain (endosperm, germ and bran) in their original proportions.

Because it contains all parts of the grain, wholemeal bread is typically darker in colour and slightly more brown than white bread, which is made using only the endosperm.

How about wholegrain bread?

Australian and New Zealand food standards define wholegrain bread as something that contains either the intact grain (for instance, visible grains) or is made from processed grains (flour) where all the parts of the grain are present in their original proportions.

That last part may sound familiar. That’s because wholegrain is an umbrella term that encompasses both bread made with intact grains and bread made with wholemeal flour. In other words, wholemeal bread is a type of wholegrain bread, just like an apple is a type of fruit.

Don’t be confused by labels such as “with added grains”, “grainy” or “multigrain”. Australian and New Zealand food standards don’t define these so manufacturers can legally add a small amount of intact grains to white bread to make the product appear healthier. This doesn’t necessarily make these products wholegrain breads.

So unless a product is specifically called wholegrain bread, wholemeal bread or indicates it “contains whole grain”, it is likely to be made from more refined ingredients.

Which one’s healthier?

So when thinking about which bread to choose, both wholemeal and wholegrain breads are rich in beneficial compounds including nutrients and fibre, more so than breads made from further-refined flour, such as white bread.

The presence of these compounds is what makes eating wholegrains (including wholemeal bread) beneficial for our overall health. Research has also shown eating wholegrains helps reduce the risk of common chronic diseases, such as heart disease.

The table below gives us a closer look at the nutritional composition of these breads, and shows some slight differences.

Wholegrain bread is slightly higher in fibre, protein, niacin (vitamin B3), iron, zinc, phosphorus and magnesium than wholemeal bread. But wholegrain bread is lower in carbohydrates, thiamin (vitamin B1) and folate (vitamin B9).

However the differences are relatively small when considering how these contribute to your overall dietary intake.

Which one should I buy?

Next time you’re shopping, look for a wholegrain bread (one made from wholemeal flour that has intact grains and seeds throughout) as your number one choice for fibre and protein, and to support overall health.

If you can’t find wholegrain bread, wholemeal bread comes in a very close second.

Wholegrain and wholemeal bread tend to cost the same, but both tend to be more expensive than white bread.

Margaret Murray, Senior Lecturer, Nutrition, Swinburne University of Technology

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Receiving a cancer diagnosis is life-changing and can cause a range of concerns about ongoing health.

Fear of cancer returning is one of the top health concerns. And managing this fear is an important part of cancer treatment.

But how likely is it to get cancer for a second time?

Why can cancer return?

While initial cancer treatment may seem successful, sometimes a few cancer cells remain dormant. Over time, these cancer cells can grow again and may start to cause symptoms.

This is known as cancer recurrence: when a cancer returns after a period of remission. This period could be days, months or even years. The new cancer is the same type as the original cancer, but can sometimes grow in a new location through a process called metastasis.

Actor Hugh Jackman has gone public about his multiple diagnoses of basal cell carcinoma (a type of skin cancer) over the past decade.

The exact reason why cancer returns differs depending on the cancer type and the treatment received. Research is ongoing to identify genes associated with cancers returning. This may eventually allow doctors to tailor treatments for high-risk people.

What are the chances of cancer returning?

The risk of cancer returning differs between cancers, and between sub-types of the same cancer.

New screening and treatment options have seen reductions in recurrence rates for many types of cancer. For example, between 2004 and 2019, the risk of colon cancer recurring dropped by 31-68%. It is important to remember that only someone’s treatment team can assess an individual’s personal risk of cancer returning.

For most types of cancer, the highest risk of cancer returning is within the first three years after entering remission. This is because any leftover cancer cells not killed by treatment are likely to start growing again sooner rather than later. Three years after entering remission, recurrence rates for most cancers decrease, meaning that every day that passes lowers the risk of the cancer returning.

Every day that passes also increases the numbers of new discoveries, and cancer drugs being developed.

What about second, unrelated cancers?

Earlier this year, we learned Sarah Ferguson, Duchess of York, had been diagnosed with malignant melanoma (a type of skin cancer) shortly after being treated for breast cancer.

Although details have not been confirmed, this is likely a new cancer that isn’t a recurrence or metastasis of the first one.

Australian research from Queensland and Tasmania shows adults who have had cancer have around a 6-36% higher risk of developing a second primary cancer compared to the risk of cancer in the general population.

Who’s at risk of another, unrelated cancer?

With improvements in cancer diagnosis and treatment, people diagnosed with cancer are living longer than ever. This means they need to consider their long-term health, including their risk of developing another unrelated cancer.

Reasons for such cancers include different types of cancers sharing the same kind of lifestyle, environmental and genetic risk factors.

The increased risk is also likely partly due to the effects that some cancer treatments and imaging procedures have on the body. However, this increased risk is relatively small when compared with the (sometimes lifesaving) benefits of these treatment and procedures.

While a 6-36% greater chance of getting a second, unrelated cancer may seem large, only around 10-12% of participants developed a second cancer in the Australian studies we mentioned. Both had a median follow-up time of around five years.

Similarly, in a large US study only about one in 12 adult cancer patients developed a second type of cancer in the follow-up period (an average of seven years).

The kind of first cancer you had also affects your risk of a second, unrelated cancer, as well as the type of second cancer you are at risk of. For example, in the two Australian studies we mentioned, the risk of a second cancer was greater for people with an initial diagnosis of head and neck cancer, or a haematological (blood) cancer.

People diagnosed with cancer as a child, adolescent or young adult also have a greater risk of a second, unrelated cancer.

What can I do to lower my risk?

Regular follow-up examinations can give peace of mind, and ensure any subsequent cancer is caught early, when there’s the best chance of successful treatment.

Maintenance therapy may be used to reduce the risk of some types of cancer returning. However, despite ongoing research, there are no specific treatments against cancer recurrence or developing a second, unrelated cancer.

But there are things you can do to help lower your general risk of cancer – not smoking, being physically active, eating well, maintaining a healthy body weight, limiting alcohol intake and being sun safe. These all reduce the chance of cancer returning and getting a second cancer.

Sarah Diepstraten, Senior Research Officer, Blood Cells and Blood Cancer Division, Walter and Eliza Hall Institute and Terry Boyle, Senior Lecturer in Cancer Epidemiology, University of South Australia

This article is republished from The Conversation under a Creative Commons license. Read the original article.