OBJECTIVE: This study investigated the association between dietary intake of polyunsaturated fatty acids (PUFAs) and peripheral neuropathy in the U.S. population. RESEARCH DESIGN AND METHODS: We analyzed data from the National Health and Nutrition Examination Survey (NHANES) 1999-2004 for adults >or=40 years of age with diagnosed diabetes, an assessment of peripheral neuropathy, and reliable 24-h dietary recall. The dietary intake of PUFAs was analyzed by peripheral neuropathy status. Multivariate logistic regression models were used to estimate the odds of having peripheral neuropathy in higher quintiles of PUFA intake compared with the lowest quintile. RESULTS: The mean dietary intake of linolenic acid was 1.25 +/- 0.07 g among adults with peripheral neuropathy, significantly lower than the 1.45 +/- 0.05 g intake among those without peripheral neuropathy. After controlling for potential confounding variables, adults whose linolenic acid intake was in the highest quintile had lower odds of peripheral neuropathy than adults in the lowest quintile (adjusted odds ratio 0.40 [95% CI 0.21-0.77]). CONCLUSIONS: Among adults with diagnosed diabetes, dietary intake of linolenic acid is positively associated with lower odds of peripheral neuropathy.