In a reversal of the self-destructive rock ‘n roll adage of “live fast, die young and have a good looking corpse”, the modern medical system is focused on encouraging us to live wisely and assisting us to progress into late age, now longer than ever in human history. The new mantra might be “live long, die fast but still have a good looking corpse”.

The emphasis on longevity is combined with the almost universal hope that we can also enjoy our later years, free of both pain and chronic illness. While doctors may speak of maximising quality adjusted life years ( QALYs) epidemiological terminology never has the same "cut through".  The effects of alcohol and smoking on lung and heart disease are well known, but these key lifestyle factors, along with poor diet and inactivity, are the preventable causes of one third of cancer deaths

In this issue of GPSpeakJasmin Ritchie of Embrace Exercise reminds us that 20 per cent of coronary heart disease world wide has been attributed to physical inactivity. Cardiac and pulmonary rehabilitation services have contributed significantly to restoring patients' confidence to manage at home after a period of hospitalisation. However, social isolation and depression can contribute to a failure to maintain an exercise program and a downward spiral in the patient's health leading to worsening disability and death. Regular review of an exercise program, particularly if it can be linked to a group exercise program, appears to have a beneficial effect on keeping people in the community and healthy. 

Adelle Purbrick of Body Balance Nutrition helps us digest the National Heart Foundation's alphabet soup of Omega-3 recommendations. If you don't know your ALA from your EPA and DHA, she can enlighten you. If you like your tofu (firm or soft), you are probably already on top of the game. For the rest of us it’s fish and eggs (omega-3 enriched) on linseed toast with canola margarine.. 

Dr Andrew Binns notes that many end of life treatments are futile, expensive and sometimes painful. Establishing and regularly reviewing a patient's end of life care plan is an essential part of aged care. He recommends the
MyChoice program first established by the NRGPN several years ago. This, along with a large array of other resources for Advanced Care Planning, are available on the NCML's ‘Healthy North Coast’ website. 

What is the secret to becoming an active aging athlete – a ‘triple-A’ if you will? This issue focuses on the perils and the pitfalls of cycling in Australia over the last 100 years. While bikes and roads have improved significantly, the motor car has replaced the horse as the most disastrous encounter for a cyclist. Dedicated cycleways, such as those discussed by Lismore Mayor, Jenny Dowell, help to reduce risk but limited funding slows progress in their construction. Avid cyclists Max Osborne, Andrew Binns and Chris Gavaghan give their various perspectives, with Darryl Pursey, the master of the local cycling fraternity, offering some practical tips for minimising risks on the road. Finally, former cyclist Charlie Hew, one of our local GPs, shows there is more than one way to cover 90 kilometres. Competing in the South African Comrades Ultra Marathon is definitely not for the faint-hearted. 

All stories in 
GPSpeak are archived on the GPSpeak website. The search box found in the top right corner of every page is an excellent way for finding an old article. If you cannot recall the MBS approved GP indications for ordering a MRI, type in "MRI" in the search box. Alternatively, if you want to know about this thing called kaizen, check it and the associated links out through a GPSpeak search. 

The northern hemisphere summer has drawn to a close. As I write, the Grand Slam tennis circuit has nearly ended, the World Cup is a wonderful memory, ditto the Commonwealth Games. The cycling tragics have 
endured the long cold nights of the Tour de France, and now Spring is in their step. It's time to get going again - "On yer bike"… but watch out for the swooping magpies ... and the errant drivers on our potholed rural roads.