Food Intake and Physical Activity Patterns Among University Undergraduate Students at Risk of Eating Disorders

<b>Background/Objectives</b>: University students are particularly vulnerable to unhealthy eating patterns and body image dissatisfaction. The association between lifestyle factors and eating disorders (EDs) can be ambiguous as healthier lifestyle choices may paradoxically be related to ED risk. In this study, we aimed to analyze physical activity (PA) and dietary patterns-specifically food type and diet quality-as lifestyle indicators in university students with and without ED risk. Motivations for engaging in PA and the association between PA levels and diet quality were also examined. <b>Methods</b>: A descriptive cross-sectional study was conducted on a convenience sample of 1982 undergraduate students aged 18-30 years from the University of the Balearic Islands. Dietary intake, diet quality, PA levels, and motivations were self-reported using a questionnaire. <b>Results</b>: Students at risk of EDs reported higher diet quality, including greater adherence to the Mediterranean diet (<i>p</i> < 0.001) and more adequate consumption of fruits (<i>p</i> < 0.001), vegetables (<i>p</i> < 0.001), and red and processed meat (<i>p</i> < 0.001). Regarding PA, participants with ED risk engaged in more weekly PA sessions (<i>p</i> < 0.001) and accumulated a longer total weekly duration (<i>p</i> = 0.019), with physical appearance being the main motivation. In participants without ED risk, PA levels were positively associated with adherence to the Mediterranean diet (<i>p</i> < 0.001); however, no such association was observed in participants with ED risk (<i>p</i> = 0.538). <b>Conclusions</b>: Students at risk for EDs exhibited comparatively healthier diet and PA patterns, seemingly driven by concerns related to body image and an aversion to energy-dense foods. Therefore, apparent health behaviors should not be used to rule out ED risk.