BACKGROUND AND AIMS: Dietary patterns and associated gut microbiota are increasingly recognized as key contributors to the development and prevention of colon polyps (CP). This study aimed to investigate whether specific dietary components and gut microbiome alterations are associated with CP incidence and severity, and to compare these patterns with other gastrointestinal or hepatic conditions. METHODS: Stool samples were collected from individuals with CP, healthy controls, and patients with alcoholic fatty liver disease (AFLD), metabolic-associated fatty liver disease (MAFLD), and ulcerative colitis (UC). Gut microbiome profiling was conducted to characterize microbial composition across groups. Dietary intake data were analyzed, with a focus on nutrient profiles and potential food contaminants. CP patients were further divided into subgroups based on polyp number (single vs. multiple) for dietary pattern comparison. RESULTS: Distinct microbiota profiles were observed among groups: Bacteroidetes dominated in CP patients, Actinobacteria in AFLD, Proteobacteria in MAFLD, and Firmicutes in UC. CP-associated microbiota were enriched in Prevotellaceae and Paraprevotellaceae. Dietary patterns linked to CP included high-fat, ketogenic, and high-sugar diets, as well as possible exposure to food contaminants. Patients with multiple polyps exhibited higher intake of calories, fat, and red meat, while those with single polyps consumed diets lower in calories and fat but richer in vitamins E and K. CONCLUSION: Food intake is strongly associated with both the incidence and severity of colon polyps, likely through modulation of the gut microbiome and nutritional environment. These findings support the potential for dietary interventions targeting gut microbial composition to prevent or mitigate CP development.