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.

Australia has one of the highest skin cancer rates globally, with nearly 19,000 Australians diagnosed with invasive melanoma – the most lethal type of skin cancer – each year.

While advanced melanoma can be fatal, it is highly treatable when detected early.

But Australian clinical practice guidelines and health authorities do not recommend screening for melanoma in the general population.

Given our reputation as the skin cancer capital of the world, why isn’t there a national screening program? Australia currently screens for breast, cervical and bowel cancer and will begin lung cancer screening in 2025.

It turns out the question of whether to screen everyone for melanoma and other skin cancers is complex. Here’s why.

The current approach

On top of the 19,000 invasive melanoma diagnoses each year, around 28,000 people are diagnosed with in-situ melanoma.

In-situ melanoma refers to a very early stage melanoma where the cancerous cells are confined to the outer layer of the skin (the epidermis).

Instead of a blanket screening program, Australia promotes skin protection, skin awareness and regular skin checks (at least annually) for those at high risk.

About one in three Australian adults have had a clinical skin check within the past year.

Why not just do skin checks for everyone?

The goal of screening is to find disease early, before symptoms appear, which helps save lives and reduce morbidity.

But there are a couple of reasons a national screening program is not yet in place.

We need to ask:

1. Does it save lives?

Many researchers would argue this is the goal of universal screening. But while universal skin cancer screening would likely lead to more melanoma diagnoses, this might not necessarily save lives. It could result in indolent (slow-growing) cancers being diagnosed that might have never caused harm. This is known as “overdiagnosis”.

Screening will pick up some cancers people could have safely lived with, if they didn’t know about them. The difficulty is in recognising which cancers are slow-growing and can be safely left alone.

Receiving a diagnosis causes stress and is more likely to lead to additional medical procedures (such as surgeries), which carry their own risks.

2. Is it value for money?

Implementing a nationwide screening program involves significant investment and resources. Its value to the health system would need to be calculated, to ensure this is the best use of resources.

Narrower targets for better results

Instead of screening everyone, targeting high-risk groups has shown better results. This focuses efforts where they’re needed most. Risk factors for skin cancer include fair skin, red hair, a history of sunburns, many moles and/or a family history.

Research has shown the public would be mostly accepting of a risk-tailored approach to screening for melanoma.

There are moves underway to establish a national targeted skin cancer screening program in Australia, with the government recently pledging $10.3 million to help tackle “the most common cancer in our sunburnt country, skin cancer” by focusing on those at greater risk.

Currently, Australian clinical practice guidelines recommend doctors properly evaluate all patients for their future risk of melanoma.

Looking with new technological eyes

Technological advances are improving the accuracy of skin cancer diagnosis and risk assessment.

For example, researchers are investigating 3D total body skin imaging to monitor changes to spots and moles over time.

Artificial intelligence (AI) algorithms can analyse images of skin lesions, and support doctors’ decision making.

Genetic testing can now identify risk markers for more personalised screening.

And telehealth has made remote consultations possible, increasing access to specialists, particularly in rural areas.

Check yourself – 4 things to look for

Skin cancer can affect all skin types, so it’s a good idea to become familiar with your own skin. The Skin Cancer College Australasia has introduced a guide called SCAN your skin, which tells people to look for skin spots or areas that are:

1. sore (scaly, itchy, bleeding, tender) and don’t heal within six weeks

2. changing in size, shape, colour or texture

3. abnormal for you and look different or feel different, or stand out when compared to your other spots and moles

4. new and have appeared on your skin recently. Any new moles or spots should be checked, especially if you are over 40.

If something seems different, make an appointment with your doctor.

You can self-assess your melanoma risk online via the Melanoma Institute Australia or QIMR Berghofer Medical Research Institute.

H. Peter Soyer, Professor of Dermatology, The University of Queensland; Anne Cust, Professor of Cancer Epidemiology, The Daffodil Centre and Melanoma Institute Australia, University of Sydney; Caitlin Horsham, Research Manager, The University of Queensland, and Monika Janda, Professor in Behavioural Science, The University of Queensland

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