Sex disparities in dietary habits and physical activity among university on-campus residents: a comparative analysis

University years are crucial for establishing healthy lifestyle habits that impact long-term health. This study specifically examines sex-based differences in dietary practices, nutritional status, and intentional physical activity patterns among on-campus residents within the conservative socio-cultural context of Pakistan. A cross-sectional study was conducted using a mixed sampling strategy, combining stratified and convenience methods. Data was collected from 222 on-campus residents (50% males). A study-specific structured questionnaire was designed for the study and was administered face-to-face. Anthropometrics, dietary patterns, multiple 24-h dietary recalls, and physical activity levels were assessed. Statistical analysis was performed using SPSS version 22.0, which included descriptive statistics, chi-square tests, and independent t-test. Findings included significant sex differences in household income distribution (ϕ = 0.19, p < 0.001), area of residence (ϕ = 0.29, p < 0.001), and BMI (males: 23.2 ± 4.7, females: 21.2 ± 3.9), males were 1.35 times more likely to be classified as overweight (BMI ≥ 25) while females have an 86% higher likelihood of being underweight (BMI < 18.5). Males were found to be 2.85 times as likely to be intentionally physically active (p < 0.001). Mean macronutrient intake showed significant differences (all p < 0.001): protein (t = -3.8), fat (t = 6.6), and carbohydrates (t = − 4.2), with distinct patterns within Acceptable Macronutrient Distribution Ranges (AMDR). These findings suggest that improving health outcomes among university on-campus residents necessitates sex-specific nutrition support and dietary recommendations, with an emphasis on tailored interventions that account for physiological differences, metabolic requirements, and individual dietary patterns.