Uncool, or simply warm?
American John Stewart says he doesn't wear thermals in his hometown in the state of Minnesota, even though it's colder than Beijing. But the 31-year-old occasionally dons them in the Chinese capital.
However, he only wears them when skiing or if he knows he'll be outside for a long time. "If I wear qiuku, I'll certainly feel too hot," Stewart says.
He guesses most foreigners in China don't wear them for the same reason.
But American Mike Fuksman, who hails from nearby Michigan, says most of his compatriots back home and foreign friends in Beijing wear thermals.
"I wasn't aware of the Chinese fondness for long johns before I came here, but, to be honest, it's not something that really entered my mind," he says.
"In my hometown, most people wear long johns. They're probably made in China, actually. They're warm and comfortable, and just great. I just wish they had pockets."
The 27-year-old says he's aware many young Chinese don't wear thermals because they're perceived as less-than-stylish.
But Fuksman takes an entirely different tact - he likes them as outerwear at home, and sometimes when he's out and about, too.
"I like wearing my long johns in public, mostly because I'm lazy, but also because they're comfortable, and I'm not particularly concerned with how strangers perceive me," he says.
"If I'm going to work or a nice dinner, naturally, I will wear normal pants. But if I'm just running to the xiaomaibu (convenience store) or hanging with close friends, long johns are just fine."
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But the health implications have never crossed Fuksman's mind, he says.
Westerners generally don't believe in the TCM edict of shouliang - that is, that chilliness not only harms health in general but also places the specific body partsexposed at special risk.
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China is also moving in this direction as the economy develops, although this trend's unevenness matches geographic imbalances.
Nanfang People Weekly journalist Wu Qi says he's less likely to wear thermals in Beijing than when visiting his hometown of Loudi city, Hunan province.
"Back home, I put on as many clothes as I can," he says.
The Central China locale is south of the Yangtze River, which central government policy designates as the dividing line for mandatory central heating. So, Loudi's winters are chilly and clammy - even indoors.
"The cold in my hometown seeps into your bones," he says. "It's unbearable."
The 26-year-old always wore thermals and padded trousers as a child, he recalls.
"But young people today don't think it's stylish," Wu says.
He believes that's because of improved living conditions and the fashion industry.
Wu wears qiuku - literally, "autumn trousers" - in the coldest month of Beijing's winter but no longer dons qiuyi - thermal shirts. He wears long-sleeved, non-thermal shirts to save face, he says.
"It's embarrassing when others see your long underwear when you take off your sweater or jacket in warm buildings," he says.
This outlook, however, isn't widely held by the older generation, which largely scoffs at youth's vanity. This is largely because of a solid belief in TCM doctrine.
But China-Japan Friendship Hospital Western and Chinese medicine doctor Jia Haizhong says traditional beliefs about qiuku are exaggerated to the point they're old wives' tales.
"The idea qiuku are crucial to health is nonsense," says the doctor in his 50s.
"Keeping the body temperature from dropping is a basic rule of Western and Chinese medicine. You need to stay warm.
"But there's no advantage to doing so with qiuku compared to other means."
Contact the writers at liuzhihua@chinadaily.com.cn and erik_nilsson@chinadaily.com.cn.