Prevalence of traditional Chinese medicine body constitutions in a large community-based study in Hangzhou, China

Abstract Background Traditional Chinese medicine (TCM) views body constitution as a foundational determinant of health and disease risk. Understanding the distribution of body constitutions across the population can help in developing personalized strategies to prevent disease, but few studies have examined composite constitutions or unbalanced tendencies. Methods This cross-sectional study assessed the prevalence of singular and composite (multiple) TCM body constitutions and tendencies in a sample of adult residents of Hangzhou, China. We used the 2016 version of the Constitution in Chinese Medicine Questionnaire (CCMQ, 54 items) to classify participants into nine body constitutions and tendencies toward those body constitutions and examined variations in those distributions by demographics and selected lifestyle factors. Results Among 8,665 participants aged 18–80 years, 74.2% had one or more body constitutions, and 25.8% had unbalanced tendencies only. The Balanced constitution was the most common (22.3%). Of the eight unbalanced constitutions, Qi Deficiency (16.4%), Phlegm Dampness (11.0%), and Yang Deficiency (9.4%) were most prevalent. Over half of the individuals with an unbalanced constitution also had other constitutions (composite). The most frequent composite combinations included Qi Stagnation with Qi Deficiency, Blood Stasis and Qi Deficiency, and Damp Heat with Phlegm Dampness. Body constitution distribution varied significantly by age, sex, and body mass index (BMI). Younger adults (18–39 years) were less likely to have the Balanced constitution (13.1%) and more likely to have composite unbalanced constitutions. Men were more likely to have Phlegm Dampness or Damp Heat, while women were more likely to have Yang Deficiency or Yin Deficiency. After adjusting for age and sex, individuals with obesity had a higher prevalence of Phlegm Dampness and a lower prevalence of the Balanced, Yang Deficiency, or Yin Deficiency constitutions. Conclusions Our results provide a comprehensive profile of the patterns and distribution of TCM body constitutions across demographic and lifestyle subgroups. This more complete understanding of TCM body constitutions can inform personalized medicine, support individual risk assessment, and help improve health outcomes.