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The exercise boom is not just a fad; it is a return to ‘natural’ activity - the kind for which our bodies are engineered and which facilitates the proper function of our biochemistry and physiology. Viewed through the perspective of evolutionary time, sedentary existence, possible for great numbers of people only during the last century, represents a transient, unnatural aberration. (Eaton, Shostak, Konner 1988, p. 168)

Archaeologists working in conjunction with medical anthropologists have established that our ancestors up through the beginning of the Industrial Revolution incorporated strenuous physical activity as a normal part of their daily lives - and not only for the daily, subsistence requirements of their "work" lives. Investigations of preindustrial societies still intact today confirm that physical capability was not just a grim necessity for success at gathering food and providing shelter and safety (Eaton, Shostak, Konner 1988). Physical activity was enjoyed throughout everyday prehistoric life, as an integral component of religious, social, and cultural expression. Food supplies for the most part were plentiful, allowing ample time for both rest and recreational physical endeavors.

Eaton, Shostak, and Konner (1988) describe a "Paleolithic rhythm" (p. 32) observed among contemporary hunters and gatherers that seems to mirror the medical recommendations for physical activity in this report. This natural cycle of regularly intermittent activity was likely the norm for most of human existence. Sustenance preoccupations typically were broken into 1- or 2-day periods of intense and strenuous exertion, followed by 1- or 2-day periods of rest and celebration. During these rest days, however, less intense but still strenuous exertion accompanied 6- to 20-mile round-trip visits to other villages to see relatives and friends and to trade with other clans or communities. There or at home, dancing and cultural play took place.

As the neolithic Agricultural Revolution allowed more people to live in larger group settings and cities, and as the specialization of occupations reduced the amount and intensity of work-related physical activities, various healers and philosophers began to stress that long life and health depended on preventing illnesses through proper diet, nutrition, and physical activity. Such broad prescriptions for health, including exercise recommendations, long predate the increasingly specific guidelines of classical Greek philosophy and medicine, which are the predominant historical focus of this chapter.

In ancient China as early as 3000 to 1000 B.C., the classic Yellow Emperor’s Book of Internal Medicine (Huang Ti 1949) first described the principle that human harmony with the world was the key to prevention and that prevention was the key to long life (Shampo and Kyle 1989). These principles grew into concepts that became central to the 6th century Chinese philosophy Taoism, where longevity through simple living attained the status of a philosophy that has guided Chinese culture through the present day. Tai chi chuan, an exercise system that teaches graceful movements, began as early as 200 B.C. with Hua T’o and has recently been shown to decrease the incidence of falls in elderly Americans (Huard and Wong 1968; see Chapter 4).

In India, too, proper diet and physical activity were known to be essential principles of daily living. The Ajur Veda, a collection of health and medical concepts verbally transmitted as early as 3000 B.C., developed into Yoga, a philosophy that included a comprehensively elaborated series of stretching and flexibility postures. The principles were first codified in 600 B.C. in the Upanishads and later in the Yoga Sutras by Patanjali sometime between 200 B.C. and 200 A.D. Yoga philosophies also asserted that physical suppleness, proper breathing, and diet were essential to control the mind and emotions and were prerequisites for religious experience. In both India and China during this period, the linking of exercise and health may have led to the development of a medical subspecialty that today would find its equivalent in sports medicine (Snook 1984).

Though less directly concerned with physical health than with social and religious attainment, physical activity played a key role in other ancient non-Greco-Roman cultures. In Africa, systems of flexibility, agility, and endurance training not only represented the essence of martial arts capability but also served as an integral component of religious ritual and daily life. The Samburu and the Masai of Kenya still feature running as a virtue of the greatest prowess, linked to manhood and social stature.

Similarly, in American Indian cultures, running was a prominent feature of all major aspects of life (Nabokov 1981). Long before the Europeans invaded, Indians ran to communicate, to fight, and to hunt. Running was also a means for diverse American Indian cultures to enact their myths and thereby construct a tangible link between themselves and both the physical and metaphysical worlds. Among the Indian peoples Nabokov cites are the Mesquakie of Iowa, the Chemeheuvi of California, the Inca of Peru, the Zuni and other Pueblo peoples of the American Southwest, and the Iroquois of the American East, who also developed the precursor of modern-day lacrosse. Even today, the Tarahumarahe of northern Mexico play a version of kickball that involves entire villages for days at a time (Nabokov 1981; Eaton, Shostak, Konner 1988).

Conclusions

1. Physical activity for better health and well-being has been an important theme throughout much of western history.
2. Public health recommendations have evolved from emphasizing vigorous activity for cardiorespiratory fitness to including the option of moderate levels of activity for numerous health benefits.
3. Recommendations from experts agree that for better health, physical activity should be performed regularly. The most recent recommendations advise people of all ages to include a minimum of 30 minutes of physical activity of moderate intensity (such as brisk walking) on most, if not all, days of the week. It is also acknowledged that for most people, greater health benefits can be obtained by engaging in physical activity of more vigorous intensity or of longer duration.
4. Experts advise previously sedentary people embarking on a physical activity program to start with short durations of moderate-intensity activity and gradually increase the duration or intensity until the goal is reached.
5. Experts advise consulting with a physician before beginning a new physical activity program for people with chronic diseases, such as cardiovascular disease and diabetes mellitus, or for those who are at high risk for these diseases. Experts also advise men over age 40 and women over age 50 to consult a physician before they begin a vigorous activity program.
6. Recent recommendations from experts also suggest that cardiorespiratory endurance activity should be supplemented with strength-developing exercises at least twice per week for adults, in order to improve musculoskeletal health, maintain independence in performing the activities of daily life, and reduce the risk of falling.

Centers for Disease Control and Prevention
National Center for Chronic Disease Prevention and Health Promotion
Division of Cancer Prevention and Control

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