The objective was to examine differences of dietary pattern, physical activity and energy balance in 240 college students with 137 of them enrolled in California State University, Los Angeles (LA) and the other 93 enrolled in China Medical University in Taichung, Taiwan (TW). A three-day dietary record and a 24-hour physical activity journal were designed to obtain data. LA was found to consume 1, 1.5, 0.8 more servings on fruits and vegetables, milk, citrus group, respectively and 1.2, 4.3 less servings on meats and beans, and grains, respectively, than those of TW with significant differences between student groups. Each group consumed 0.7 serving dark greens per day. Both groups did not obtain the recommended "5 A Day" servings of fruits and vegetables. For physical activity, although LA spent 1033.4 plus or minus 734.0 kcal/day on physical activity, 400 kcal more than TW (607.6 plus or minus 507.3 kcal/day) but LA had 400 more kcal total energy intake (1720.9 [plus or minus 624.8 kcal/day) than those of TW (1306.9 plus or minus 429.3 kcal/day). As a result, LA's energy balance (-995.5 plus or minus 1023.8 kcal/day) was not significantly different from TW (-894.4 plus or minus 696.6 kcal/day). The TW group seemed to have a more sedentary life style than the LA group. Multiple lifestyle modification, including dietary pattern, physical activity and energy balance, should be taken into consideration altogether by college students to promote their health. (Contains 3 tables.)