A new study in the American Journal of Cardiology shows that only vigorous physical activity, not moderate exercise, meaningfully reduces cardiovascular disease (CVD) risk in young adults. The finding has clear implications for Thailand, where heart disease remains the leading cause of death. The research suggests that Thais should aim for higher-intensity activity to better protect heart health, beyond simply “moving more.”
Across the world and in Thailand, cardiovascular disease remains a major public health challenge. Data from the World Health Organization indicate CVD causes more deaths than any other illness. Thailand has actively promoted physical activity in recent years through government campaigns encouraging walking, cycling to work, and community fitness events. Earlier national plans focused on raising overall activity levels, but did not consistently distinguish between moderate and vigorous intensity.
The study followed 196 Latino men aged 18 to 40, using accelerometers to measure daily activity over a week. Cardiovascular risk was assessed with the Framingham Risk Score, a trusted tool for estimating long-term CVD risk. Both low- and high-risk groups met the general guideline of at least 150 minutes per week of moderate-to-vigorous activity. The difference lay in vigorous activity: the low-risk group averaged 25 minutes per day, nearly double the high-risk group’s 12 minutes.
Analysis revealed that every additional minute of vigorous activity per day reduced the odds of being in the high-risk category by about 4.4%, even after accounting for age, BMI, diet, and smoking. In contrast, time spent on moderate activity showed no significant association with CVD risk. These results challenge the assumption that moderate exercise alone provides robust heart protection in young adults.
Thai health experts have long warned that physical inactivity, combined with unhealthy diets and tobacco use, drives rising rates of heart disease and other noncommunicable diseases. Thailand’s Ministry of Public Health and the Thai Health Promotion Foundation have promoted physical activity through national programs and campaigns, with support from international partners like the World Health Organization. Thailand’s current guidelines encourage adults to accumulate 75 minutes of vigorous-intensity activity or 150 minutes of moderate-intensity activity weekly. Yet many Thais remain insufficiently active, including significant portions of children and adults.
Urbanization, car-centric transport, and sedentary work contribute to lower daily energy expenditure in Thailand, especially in Bangkok. A large study of over 80,000 Thai adults with type 2 diabetes indicated rising predicted 10-year CVD risk, driven in part by increasing BMI and blood pressure—factors that can be mitigated through exercise. The evidence points to a need for more vigorous options within public health messaging, such as faster cycling, running, high-intensity group workouts, and interval training. Community programs and gym-based initiatives are gaining traction among younger Thais.
Experts emphasize adapting strategies to Thai life. A senior official from the Thai Health Promotion Foundation says communities should promote brisk movement, cycling, and high-energy dance as accessible options for all ages. International guidance from the WHO also stresses that lasting behavioral change requires coordinated action across government, civil society, and the private sector to create safe, welcoming spaces for vigorous exercise.
Cultural practices can support high-intensity activity. Traditional activities like Muay Thai and growing community cycling clubs offer authentic channels to raise heart rates while honoring Thai identity. Targeted strategies may differ by region; urban residents may need more safe spaces and structured programs, while rural communities can integrate vigorous activity into daily routines and local customs.
Looking ahead, revising exercise guidelines to clearly separate moderate and vigorous intensity could help schools, workplaces, and community centers design better programs. Technology, such as fitness trackers and mobile apps, can assist people in monitoring intensity and staying motivated. For individuals with health conditions or those new to exercise, medical guidance should tailor safe entry points into higher-intensity routines.
Key takeaways for Thais aiming to lower heart risk:
- Strive for at least 75 minutes of vigorous exercise weekly, or increase the intensity of existing activities.
- Include multiple sessions of higher-intensity movement each week, such as running, fast cycling, Muay Thai, or vigorous group aerobics.
- Use a simple talk test: if speaking is difficult in full sentences, the workout is likely vigorous.
- Encourage schools, workplaces, and community groups to offer programs combining moderate and vigorous activity.
- If you have health concerns or are new to exercise, consult a healthcare provider before starting high-intensity training.
- Adapt traditional activities to raise heart rate more effectively, for example through faster styles of dance or martial arts.
In sum, Thailand’s health strategy should align with the latest science by emphasizing vigorous activity alongside diet, tobacco control, and blood pressure management. The country’s social fabric—its communal sports, parks, and martial arts heritage—positions Thai communities well to embrace a more active, heart-healthy era.
For practitioners and policymakers, practical steps include updating school curricula, expanding access to vigorous activities in community centers and workplaces, and leveraging technology to support intensity tracking. Public messaging should celebrate achievable high-intensity options for all fitness levels, making heart-health gains a realistic national ambition.