Determinants of Healthy Eating Knowledge and Practices Among Undergraduate Students at Muhimbili University of Health and Allied Sciences: A Cross-Sectional Study

Background. Poor dietary quality among university students in sub-Saharan Africa contributes to rising diet-related non-communicable diseases. Evidence on healthy eating knowledge, practices, and their determinants among Tanzanian undergraduates remains limited. Objectives. To evaluate healthy eating knowledge and dietary practices among undergraduates students at Muhimbili University of Health and Allied Sciences (MUHAS) and to examine associations with sociodemographic, environmental, economic, social, and cultural factors. Methods. A cross-sectional survey recruited 337 students (response rate 91.1%) through stratified random sampling. Data were analysed using Pearson chi-square tests, Fisher's exact tests, and Cramér's V. Results. High knowledge was present in 56.4% (95% CI: 51.0%, 61.6%), with no significant sociodemographic associations. Good practice was present in 52.2% (95% CI: 46.9%, 57.5%). Year of study was strongly associated with practice (χ²(3) = 63.74, p < .001, V = 0.44); good practice declined from 70.2% (Year 1) to 12.5% (Year 4). Financial constraint restricted food choices for 75.4%. Conclusions. A knowledge-practice gap coexists with progressive dietary deterioration across academic years. Institutional food-environment policy, financial support, and peer-based nutrition interventions are recommended.