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Recommended physical activity and all cause and cause specific mortality in US adults: prospective cohort study

BMJ 2020; 370 doi: (Published 01 July 2020) Cite this as: BMJ 2020;370:m2031

Rapid Response:

Old physical activity guideline

Dear Editor,

I congratulate Zhao and colleagues for their very interesting research article about the association of recommended physical activity and all cause and cause specific mortality in the current issue of BMJ [1]. Once again proven: Exercise is and remains the cornerstone of robust good health because it significantly prevents a wide range of diseases, maintains everyday motor skills, and underpins our mental health and sense of well-being.

In this context, it is hardly known that the physician Christoph Schorer (1618-1671) from Memmingen in Germany wrote over 340 years ago one of the first recommendations on physical activity for health in the German language for the general population. He already recommended at that time, for example, a 30 minute walk every morning and regular interruptions to prolonged sitting time [2]. In his "Rules of Health", Schorer advised a moderate lifestyle and balance. In addition to chapters on air, food and drink, he formulated thirteen physical activity recommendations in the chapter 'On Exercise'. In his first rule it says: "Exercise is very necessary for maintaining good health." And in the thirteenth recommendation he wrote, for example [3]: "Those who write a lot and study in a seated position, indeed all those who must have a seat leather, should at least spend half an hour before and after lunch and dinner doing an exercise at least with walking up and down." In the following chapter 'On Rest' Schorer again underlines: "Except in cases of need, sitting or lying down is harmful and causes a lot of illness."

According to Schorer, too, the possibilities of physical activity in today's nervous age, from childhood to old age, urgently need to be cultivated more intensively and robust public infrastructures created for the population-wide desire for movement. In conclusion, the physician wrote in 1677 [3]: "My dear friends, who read this and my health rules, do not mock your physical and mental health, let them be better applied to you, accept with a good mind what I have written from a good heart; and believe that if these rules, when you observe them as much as possible, do not prevent you from death, they will be able to save and protect you from many diseases and pains."


1. Zhao M, Veeranki SP, Magnussen CG, Xi B. Recommended physical activity and all cause and cause specific mortality in US adults: prospective cohort study BMJ 2020;370:m2031. doi: 10.1136/bmj.m2031.
2. Hofmeister M. Physical activity tips from the 17th Century. Bewegungstherapie und Gesundheitssport 2015;31:205-207. doi: 10.1055/s-0035-1550126. [German].
3. Schorer C. Rules of health, travelers and natives, high and low, scholars and unlearned, useful to read and even more useful to follow. Augsburg, Germany: Göbels; 1677. [German].

Competing interests: No competing interests

02 July 2020
Martin Hofmeister
Nutrition Scientist (PhD)
Consumer Centre of the German Federal State of Bavaria, Department Food and Nutrition, Germany
Mozartstraße 9, D-80336 Munich, Germany