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

Year: 2026

Type: article

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.

Source: Frontiers in Medicine

DOI: 10.3389/fmed.2026.1973268

Authors: Cheng-Hung Lee, Yi-Chang Su, Chia-Ing Li, Chuan-Wei Yang, Tsai-Chung Li