Foods associated with precancerous colorectal adenoma, especially those associated with large adenomas, are poorly understood. We compared food intake in polyp-free controls (n = 427) with small adenoma (n = 154) or large adenoma (n = 208) cases in Burgundy (France). Logistic regression models controlled for age, gender, and energy. Consumption of lean meat was associated with a reduced risk of small adenomas odds ratio (OR) for 4th vs. 1st quartile = 0.3, 95% confidence interval (CI) = 0.2-0.6 and large adenomas (OR = 0.4, 95% CI = 0.3-0.7) compared with controls. There was an increased risk with pâtés and meat spread OR = 2.1, 95% CI = 1.1-3.7 (small adenomas) and OR = 2.6, 95% CI = 1.5-4.4 (large adenomas), bread OR = 2.0, 95% CI = 1.1-3.6 (small adenomas) and OR = 2.2, 95% CI = 1.3-3.7 (large adenomas), and pasta (OR = 1.7, 95% CI = 0.9-3.0 in small adenomas only). Animal fats were associated with an increased risk of large adenomas compared with small adenomas (OR = 2.4, 95% CI = 1.1-5.0), whereas yogurt intake was associated with a lower risk (OR for high vs. no intake = 0.5, 95% CI = 0.3-0.9). These findings suggest that some risk factors that have been found to be associated with cancer, such as refined cereal products and high-fat animal products, also influence early stages of colorectal carcinogenesis.