A groundbreaking new study published in the Annals of Internal Medicine has found that people with diabetes who pack their required weekly exercise into one or two sessions — often dubbed ‘weekend warriors’ — can dramatically lower their risk of death, especially from heart disease, by up to 33%. This revelation could change the way Thais with diabetes and tight schedules approach physical activity, making the journey to better health easier to fit into the demands of daily life. Medical News Today
Diabetes is a pressing health concern in Thailand, with the Ministry of Public Health estimating nearly five million Thais currently living with the disease—often undiagnosed until complications arise. The risk of heart disease, stroke, and kidney problems remains significantly higher in Thai diabetic populations, placing a heavy burden on families and the nation’s healthcare system. Health authorities and community leaders continuously stress the importance of lifestyle modification, such as improving diet and increasing physical activity, but time and accessibility barriers persist across wide swathes of Thai society.
In the new study, researchers led by a postdoctoral fellow at Harvard School of Public Health analyzed data from over 51,000 adults with self-reported diabetes, with an average age of about 60 years, collected through the US National Health Interview Survey. Participants were grouped into four exercise patterns: regularly active (150+ minutes/week spread over three or more sessions), ‘weekend warriors’ (150+ minutes/week in just one or two sessions), insufficiently active (less than 150 minutes/week), and inactive (no moderate-to-vigorous physical activity, MVPA).
The American Diabetes Association and Thailand’s own health guidelines recommend at least 150 minutes per week of MVPA, such as brisk walking, jogging, energetic dancing, or playing sports like basketball. Importantly, only about half of people with diabetes globally actually meet these guidelines, often citing lack of time or access to facilities—a familiar problem in bustling Thai cities and rural provinces alike.
Remarkably, the study found that ‘weekend warriors’ experienced a 21% lower risk of death from any cause, and a 33% drop in cardiovascular death risk compared to their completely inactive peers. Regularly active participants also significantly benefited: a 17% reduction in all-cause mortality and a 19% reduction in heart-related deaths. Notably, even those who were “insufficiently active” enjoyed lower risks than those who did not exercise at all, underscoring the message that “any movement is better than none.”
Lead author and Harvard-based researcher explained, “We found that ‘weekend warriors’ had similar reductions in all-cause and cardiovascular mortality as those who exercised more regularly, as long as they reached the recommended weekly MVPA amount. This is important because many people struggle to meet current exercise guidelines that recommend activity spread over multiple days per week. Our findings suggest a more flexible approach—like doing 150 minutes of exercise just on weekends—can still provide comparable health benefits and may be easier to stick with for people with busy schedules—demanding work schedules, family responsibilities, or limited access to safe and convenient exercise facilities nearby.” Medical News Today
A prominent hospital cardiologist from MemorialCare Saddleback Medical Center, also commenting on the study, highlighted the clinical significance: “This prospective cohort study found that exercising at least 150 minutes per week over one to two sessions was associated with a 33% lower risk of cardiovascular mortality in patients with diabetes. These results highlight the importance of incorporating physical activity into one’s lifestyle in order to reduce the risk of cardiovascular disease, especially in people with other known risk factors such as diabetes.”
An expert in cardiology at JFK University Medical Center in New Jersey called the practice-changing findings “cautiously optimistic and practically exciting,” noting, “The finding that weekend warriors achieved nearly equivalent mortality benefits to those exercising regularly throughout the week is genuinely practice-changing. This challenges the conventional wisdom that exercise must be spread evenly across the week to be maximally beneficial.” Medical experts echoed that for people with diabetes who face work and family barriers to daily exercise, the ‘weekend warrior’ strategy could be both practical and lifesaving.
For Thailand, where nearly everyone has witnessed a relative or neighbour burdened by diabetes, these new findings take on special urgency. According to the World Health Organization’s 2023 data, diabetes prevalence continues to rise in the Kingdom—partly due to urban lifestyles and shifting diets—making exercise promotion a top priority for public health campaigns. The study’s flexibility aligns well with Thai working culture, where long hours and family commitments are often cited as obstacles to daily exercise routines. Community-based exercise sessions, weekend walking groups, temple fairs featuring dance or traditional Muay Thai workouts, and even cycling events organized by local authorities could be key platforms for delivering these health benefits at scale throughout the country.
Importantly, the research also affirms the Thai Ministry of Public Health’s broader strategy of promoting “Active Thailand,” a campaign encouraging Thais to find creative ways to incorporate activity into their lives. Many Bangkok office workers, for example, have already begun to walk or jog around city parks on weekends—such as Lumphini or Benjakitti Park—where bustling crowds gather for relaxation and fitness. Likewise, residents in the North and Northeast increasingly participate in cycling weekends or community aerobics during temple fairs, showing the cultural feasibility of the ‘weekend warrior’ approach.
Looking further back, traditional Thai culture has long valued periodic, intense bursts of activity—such as the energetic mass dances during Loy Krathong or Songkran. This historical context gives confidence that new exercise models won’t be foreign to Thai communities but could, in fact, be woven into the existing fabric of local life.
For those concerned about safety, experts recommend starting with moderate activities and gradually increasing intensity as tolerance grows. People living with diabetes should consult their healthcare provider before beginning new workout regimens, especially if they have existing cardiovascular or orthopedic conditions. Community health workers or local hospitals often offer free screenings and exercise counseling, particularly around national health days or royal birthdays—providing an ideal entry point for Thai patients seeking guidance.
Looking to the future, researchers acknowledge that further studies—using wearable devices rather than self-reports—will be crucial for validating these findings across different cultures and healthcare contexts. For now, the evidence shows any move toward more activity—regardless of schedule—can substantially improve the odds for Thais with diabetes. Digital health tools and expanding fitness infrastructure, including more parks and bike lanes supported by the Bangkok Metropolitan Administration, will enhance equitable access to exercise opportunities for people of all backgrounds.
The practical takeaway for Thai readers: you don’t need to exercise every day to reap major health rewards. Whether it’s a Saturday hike in Khao Yai, Sunday Zumba at the community center, or several hours of gardening at the family home, concentrated weekend activity can add years to your life and dramatically cut risk from the nation’s most feared health threats. As a senior research fellow observed, “You don’t have to be perfect to benefit. Simply starting to move—even in small amounts—can make a meaningful difference in your long-term health.”
For best results, people with diabetes should:
- Aim for at least 150 minutes per week of moderate-to-vigorous activity, even if only possible over one or two sessions.
- Choose activities you enjoy and can reasonably sustain—dancing, group sports, brisk walking in local parks, even house cleaning.
- Consult your healthcare provider before starting if you have other health conditions or are new to exercise.
- Encourage family or friends to join; shared activity boosts motivation and social wellbeing.
- Take advantage of community or temple-based fitness events, which reduce barriers and offer accessible, culturally familiar forms of movement.
Any movement matters. The next step, as this study recommends, is simply to begin. Together, with flexible new guidance and Thai cultural strengths, the nation can turn the tide on diabetes and enjoy longer, healthier lives.
Sources: Medical News Today | World Health Organization, Thailand NCDs Profile 2023