A new clinical study suggests that the popular “5:2” intermittent fasting diet—where individuals eat normally for five days and consume very low calories on two non-consecutive days each week—could be the most flexible and effective approach for weight loss and blood glucose improvement in people with obesity and type 2 diabetes. The research, recently presented at the Endocrine Society’s ENDO 2025 conference in San Francisco, compared three well-known dietary strategies and found that all offer benefits, but the intermittent approach may provide unique advantages for those struggling to manage diabetes and weight.
Type 2 diabetes, a condition where the body cannot effectively control blood sugar due to insulin resistance, is a mounting health crisis both in Thailand and globally. Estimates indicate nearly 10% of the world’s population could be affected by 2050, a statistic mirrored by rising prevalence in Thailand’s urban and rural populations according to the Ministry of Public Health (WHO diabetes facts). Obesity remains the leading risk factor for developing type 2 diabetes, and sustained weight loss is widely recognized by Thai and international health authorities as a crucial management tool—sometimes even leading to partial or complete remission (CDC diabetes remission research).
Researchers at The First Affiliated Hospital of Zhengzhou University in China recruited 90 adults diagnosed with obesity and type 2 diabetes, randomly assigning them to one of three diet regimens: intermittent energy restriction (IER, or the 5:2 approach), time-restricted eating (TRE), or continuous energy restriction (CER), with all groups receiving carefully monitored weekly calorie guidelines. After 16 weeks, 63 participants had completed the trial, with all groups achieving significant improvements in weight loss and blood sugar control.
The findings indicate that participants across the three groups lost an average of 7.5 kilograms (approximately 16.5 pounds), and reduced their long-term blood glucose as measured by HbA1c by more than one percentage point. Notably, those following the 5:2 pattern (IER) achieved slightly greater reductions in fasting blood glucose, insulin resistance, and blood triglycerides, as well as higher rates of adherence (85%) compared to other methods.
As the study’s lead researcher, chief physician and PhD at the First Affiliated Hospital, stated, “All three dietary approaches—I.E.R., T.R.E., and C.E.R.—were beneficial because they reduced total calorie intake, a key factor in improving glycemic control (HbA1c) and promoting weight loss in obese individuals with type 2 diabetes. Regardless of the method, calorie restriction facilitated weight loss, reducing insulin resistance and improving glycemic control.” He emphasized the practicality of the 5:2 approach, highlighting its flexibility: “Allowing normal eating for five days and calorie restriction on two non-consecutive days may be easier to sustain than daily restrictions or strict eating windows.”
The 5:2 diet regimen in this study required limiting calories to just 500–600 kcal on two fasting days, with normal calorie intake allowed for the other five days—a routine that mirrors the diet popularized internationally and increasingly adopted by health-conscious Thais. In contrast, the TRE group was restricted to eating within a 10-hour window daily (6–8am to 4–6pm), while the CER group followed a constant low-calorie diet every day without time restrictions (Medical News Today coverage).
Despite these differences, Dr. David M. Cutler, a board-certified family medicine physician at Providence Saint John’s Health Center in Santa Monica, who was not involved in the study, cautioned that “there was no statistically significant difference between the three groups for these measures,” yet all forms produced measurable benefits. Dr. Cutler added, “The fact that only 63 of the 90 patients actually completed the study speaks to the fact that adhering to dietary restrictions is difficult,” underscoring the reality Thai patients face when making lifestyle changes.
For Thai readers thinking about dietary modifications, it is important to recognize the study’s context and applicability. The trial was performed in China with relatively young adults (average age of 36.8) and a relatively short diabetes duration of 1.5 years—a demographic not always typical of Thailand’s increasingly older diabetic population. Still, the study’s central message—that sustainable calorie restriction, regardless of method, can yield significant improvement—is echoed by Thai endocrinologists and nutritionists (Bamrasnaradura Hospital diabetes guidelines, in Thai).
The 5:2 approach could be particularly suited to Thai lifestyles, where family meals and social gatherings often play a central role. Nutrition experts at leading Thai academic hospitals have long warned that rigid daily restrictions are unlikely to be sustained amid the country’s dynamic food culture, often centered on communal eating and festivals. By contrast, a flexible plan that allows normal eating most of the week could reduce the sense of deprivation and help individuals maintain healthy habits longer.
While the clinical trial reported high compliance rates with the 5:2 method, researchers stress that no single approach suits everyone. “The choice should be individualized, considering patient preferences, lifestyle, and adherence capacity,” the lead researcher told Medical News Today. He advocates for personalized nutrition plans shaped by consultation with registered dietitians.
Evidence from both Thai and international sources shows that dietary adherence—sticking with a plan over the long term—matters more for blood sugar and weight outcomes than the specific brand of restriction (JAMA Network OnDiet study). Experts point out that any plan that achieves ongoing calorie reduction, whether through intermittent or daily focus, helps manage or even reverse type 2 diabetes if maintained.
This is crucial in Thailand, where new cases of type 2 diabetes are rising consistently, especially in younger age groups, according to the Ministry of Public Health. Urbanization, increased availability of calorie-dense processed foods, and a decline in traditional active lifestyles have contributed to the surge. Given such trends, practically actionable, culturally sensitive solutions are urgently needed.
Historically, many Thais have turned to traditional fasting during Buddhist Lent or other religious observances as a means of self-discipline and spiritual cleansing. Modern intermittent fasting regimens may align well with these longstanding cultural practices, allowing for a sense of continuity while meeting health needs. However, health experts caution that patients with type 2 diabetes should never embark on fasting or calorie restriction without close medical supervision, since rapid changes in calorie intake can affect medications and blood sugar stability.
Looking forward, the Chinese study’s authors and independent commentators alike call for more research on the long-term sustainability of these diets, their psychological impacts, and their effects across broader and more diverse populations. They also note that lifestyle interventions must always be personalized, factoring in age, diabetes duration, concurrent treatments, and individual cultural context.
For Thais considering dietary changes, the consensus from both the study and local experts is clear: the best diet is one you can stick to. Those struggling with weight or newly diagnosed with type 2 diabetes are encouraged to discuss options with their healthcare provider—be it the 5:2 diet, time-restricted eating, or traditional calorie reduction—and ensure they are receiving adequate nutritional support. Simple principles, such as reducing processed food intake, emphasizing vegetables, and staying physically active, remain foundational to diabetes management.
For anyone interested in exploring the 5:2 approach, practical tips include pre-planning “fasting” days, enlisting social or family support, prioritizing low-calorie but filling options like nam prik with raw vegetables, and vigilant monitoring of blood sugar—particularly among those on medication. Participation in diet support groups at local public health centers or hospitals can provide ongoing motivation and accountability.
In summary, while no miracle diet exists, the newest research confirms that various forms of calorie restriction—including the flexible 5:2 model—can help people with type 2 diabetes manage their condition and shed excess weight. The most important step is taking action, with guidance from diabetes specialists and nutrition professionals attuned to Thailand’s rich food culture and diverse health needs.
For more information on diabetes management options and support in Thailand, readers can consult resources from the Thai Association of Diabetes Educators (TADE website) or inquire at their nearest hospital.