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Peer-reviewedCC BYFrontiers in medicine

Associations between sex and traditional Chinese medicine body constitutions: the potential role of lifestyle behaviors in a cross-sectional study

  • Cheng-Hung Lee1
  • Yi-Chang Su2
  • Chia-Ing Li3
  • Chuan-Wei Yang3
  • Tsai-Chung Li4
4 affiliations
  1. 1Department of Traditional Chinese Medicine, Taichung Veterans General Hospital , ,
  2. 2National Research Institute of Chinese Medicine, Ministry of Health and Welfare , ,
  3. 3Department of Medical Research, China Medical University Hospital , ,
  4. 4Department of Public Health, College of Public Health, China Medical University , ,
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Abstract

Introduction: This study investigated whether smoking, alcohol consumption, and physical inactivity mediate the associations between sex and Traditional Chinese Medicine body constitutions.

Methods: We analyzed data from 35,456 adults aged >18 years enrolled in the Taiwan Biobank. Body constitutions (yang deficiency, yin deficiency, and phlegm-stasis) were assessed using the Body Constitution Questionnaire (BCQ). The BCQ consists of 44 items. Each item is rated on a five-point Likert scale ranging from 1 (“never”) to 5 (“always”), with higher scores indicating a greater tendency toward the corresponding body constitution. Lifestyle behaviors included smoking, alcohol consumption, and leisure-time physical inactivity. Multivariable logistic regression and mediation analyses were performed.

Results: Female sex was independently associated with increased odds of yang deficiency [odds ratio (OR) = 2.52, 95% confidence interval (CI): 2.34–2.71], yin deficiency (OR = 2.09, 95% CI: 1.95–2.25), and phlegm-stasis (OR = 3.03, 95% CI: 2.79–3.30). Smoking showed significant negative indirect association, whereas alcohol consumption exhibited minimal mediation. Physical inactivity statistically accounted for approximately 6% of the observed associations between female sex and all three body constitution patterns.

Discussion: Women were more likely than men to exhibit yang deficiency, yin deficiency, and phlegm-stasis constitutions. Lifestyle behaviors explained only a small proportion of these sex differences. Given the cross-sectional design, these findings should be interpreted as statistical associations rather than evidence of causal mediation.

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Cite

BibTeXRIS
BibTeX
@article{lee2026associations,
  title = {{Associations between sex and traditional Chinese medicine body constitutions: the potential role of lifestyle behaviors in a cross-sectional study}},
  author = {Cheng-Hung Lee and Yi-Chang Su and Chia-Ing Li and Chuan-Wei Yang and Tsai-Chung Li},
  journal = {Frontiers in medicine},
  year = {2026},
  month = oct,
  doi = {10.3389/fmed.2026.1973268},
  url = {https://europepmc.org/article/PMC/PMC13727733},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Associations between sex and traditional Chinese medicine body constitutions: the potential role of lifestyle behaviors in a cross-sectional study
AU  - Cheng-Hung Lee
AU  - Yi-Chang Su
AU  - Chia-Ing Li
AU  - Chuan-Wei Yang
AU  - Tsai-Chung Li
PY  - 2026
DA  - 2026/10/20
JO  - Frontiers in medicine
DO  - 10.3389/fmed.2026.1973268
UR  - https://europepmc.org/article/PMC/PMC13727733
AB  - Introduction: This study investigated whether smoking, alcohol consumption, and physical inactivity mediate the associations between sex and Traditional Chinese Medicine body constitutions.  Methods: We analyzed data from 35,456 adults aged >18 years enrolled in the Taiwan Biobank. Body constitutions (yang deficiency, yin deficiency, and phlegm-stasis) were assessed using the Body Constitution Questionnaire (BCQ). The BCQ consists of 44 items. Each item is rated on a five-point Likert scale ranging from 1 (“never”) to 5 (“always”), with higher scores indicating a greater tendency toward the corresponding body constitution. Lifestyle behaviors included smoking, alcohol consumption, and leisure-time physical inactivity. Multivariable logistic regression and mediation analyses were performed.  Results: Female sex was independently associated with increased odds of yang deficiency [odds ratio (OR) = 2.52, 95% confidence interval (CI): 2.34–2.71], yin deficiency (OR = 2.09, 95% CI: 1.95–2.25), and phlegm-stasis (OR = 3.03, 95% CI: 2.79–3.30). Smoking showed significant negative indirect association, whereas alcohol consumption exhibited minimal mediation. Physical inactivity statistically accounted for approximately 6% of the observed associations between female sex and all three body constitution patterns.  Discussion: Women were more likely than men to exhibit yang deficiency, yin deficiency, and phlegm-stasis constitutions. Lifestyle behaviors explained only a small proportion of these sex differences. Given the cross-sectional design, these findings should be interpreted as statistical associations rather than evidence of causal mediation.
SN  - 2296-858X
ER  -