The purpose of this study was to assess level of awareness and knowledge of selected dietary behaviors and related diseases between American and Chinese college students. A modified United States Department of Agriculture “What We Eat in America” instrument was used. Data were collected from convenience samples of 50 American students attending Louisiana Tech University and 31 Chinese students attending Capital University of Medical Science, Beijing, China. Within the total population, 80.6% of Chinese students reported awareness of health problems caused by all seven dietary behaviors, as opposed to only 62% of American students. American students scored higher in knowledge of diseases associated with calcium (P = .008), while Chinese students scored higher in knowledge of diseases associated with increased fat intake (P = .028), increased sugar intake (P = .011), and being overweight (P = .011). When overall knowledge was categorized as low, medium, or high, significantly more Chinese students were categorized in the high knowledge group (P = .04) than Americans. Significant differences in knowledge within the Chinese population based on gender were found. Males had higher overall knowledge of diseases associated with dietary behaviors than female Chinese students (P = .039). The results of this study show that awareness of diet-related health problems does not necessarily indicate knowledge of diseases that are associated with dietary behaviors. The need for nutrition education to disseminate knowledge of potential consequences of dietary behaviors continues to be apparent, and targeted education would be appropriate in both American and Chinese college populations.