A new clinical trial identifies the 5:2 intermittent fasting plan as the most effective and sustainable option among three popular diets for improving blood sugar control in people with type 2 diabetes and obesity. Presented at ENDO 2025 in San Francisco, the findings carry meaningful implications for Thailand, where diabetes is rising and dietary trends are closely watched by clinicians and the public.
Thailand faces a growing diabetes burden, with more than seven million people living with the condition as of 2023, many of them overweight or obese. The Thai Ministry of Public Health has long emphasized dietary modification as central to diabetes care, yet selecting an accessible and effective plan remains challenging. A Thai-focused summary of the study highlights the potential value of structured intermittent fasting within a comprehensive management approach.
In the Zhengzhou University study, 90 adults newly diagnosed with type 2 diabetes and obesity were divided into three diet groups: intermittent energy restriction (IER, the 5:2 fasting method), time-restricted eating (TRE, a 10-hour daily eating window), and continuous energy restriction (CER, standard daily calorie reduction). Over 16 weeks, nutritionists supervised participants to ensure adherence and consistency.
All three diets yielded weight loss and improved long-term glucose control, measured by HbA1c. Yet the 5:2 fasting group achieved the strongest metabolic benefits, including greater reductions in fasting blood sugar, improved insulin sensitivity, and lower triglyceride levels. This group also had the highest adherence rate at 85%, outpacing the CER group and outperforming TRE. The supervised design helps ensure that observed differences reflect the diet strategies themselves rather than external factors.
“The twice-weekly fasting approach balances effectiveness with practicality,” stated the lead researcher, a senior physician at Zhengzhou University. With only two fasting days per week, participants could maintain normal eating on other days, reducing dropout risk and making adherence more feasible in real life.
Importantly, the study reported no significant differences in mild hypoglycemia or adverse effects among the groups when supervised, underscoring the safety of intermittent fasting within appropriate medical guidance. This is particularly relevant in Thailand, where concerns about low blood sugar can hinder dietary changes. Thai endocrinologists and the study team emphasize individualized assessment, as medication regimens and health status vary.
Participants averaged a BMI of 31.7, with most being male and recently diagnosed with diabetes. HbA1c reductions were greatest in the 5:2 group, translating into lower risk for complications such as neuropathy and kidney or heart disease. This relevance is high for Thailand, where diabetes-related disabilities and reduced quality of life remain pressing public health issues.
The findings resonate with Thai healthcare professionals and patients. Traditional Thai meals, rice-centered diets, and rising urban lifestyle factors contribute to the diabetes burden. Intermittent fasting aligns with cultural practices of dietary restraint observed in Buddhist traditions and can be integrated with Thai meals that emphasize vegetables and moderate carbohydrates. A senior endocrinologist at a major Bangkok hospital notes that clinicians can recommend intermittent fasting for appropriate patients when paired with culturally familiar meals, while stressing careful monitoring for those with advanced disease or multiple medications.
Strengths of the trial include its randomized, controlled design and focus on both biomedical outcomes and patient adherence. Adherence is especially important in Thailand, where work pressures, family responsibilities, and economic factors influence long-term dietary changes. The study’s four-month scope provides early signals, but longer follow-up is needed to determine sustained benefits for Thais with longstanding diabetes or more complex treatment plans.
Caveats remain. The participants had newly diagnosed diabetes without major complications, so applicability to older patients or those with advanced disease is uncertain. Real-world dietary quality and food choices could affect fasting outcomes, even with supervision.
Thailand’s public health landscape continues to evolve. Campaigns to reduce sugar in beverages and improve school meals are encouraging, yet youth obesity and diabetes risk persist. New research on intermittent fasting adds a promising option, but effective implementation will require culturally appropriate counseling and patient support. Data from Thailand’s public health system shows the ongoing need for practical, science-backed dietary guidance that respects local eating patterns.
Globally, intermittent fasting has attracted attention for metabolism, heart health, and weight control. Direct head-to-head comparisons in diabetic populations have been scarce, making this trial a meaningful addition to the evidence base. For Thailand, the results offer a potential pathway to improve diabetes management while honoring local dietary customs.
Looking ahead, Thai research institutions plan to explore intermittent fasting further within Southeast Asia, examining its impact on traditional eating patterns, patient satisfaction, and long-term metabolic markers. As interest grows, clinicians are urged to provide culturally sensitive counseling and ongoing support, not merely adopt Western dieting trends.
For Thais considering new dietary approaches, practical steps include discussing fasting protocols with a healthcare provider, aligning fasting with Thai meals rich in vegetables and moderate carbohydrates, and approaching change gradually for sustainability. Community education and support groups—whether in temples or online—can help improve adherence and reduce isolation during lifestyle changes.
In sum, with diabetes rising and the need for feasible, effective options clear, twice-weekly intermittent fasting offers a promising, culturally adaptable path for Thailand. By combining robust science with Thai values and daily routines, diabetes care can become more accessible and personally meaningful.
If considering a new dietary regimen, especially for those on diabetes medications, consult a qualified medical professional. Small, thoughtful changes—such as introducing a fasting day under supervision or substituting white rice with whole grains—can yield meaningful benefits when tailored to individual needs.