BackgroundCardiovascular diseases (CVDs) remain the leading cause of mortality worldwide. This underlies the need to evaluate different targets, such as diet quality. In this regard, we conducted the present study to find whether the healthy eating index-2015 (HEI-2015) score is associated with a 10-year risk of CVDs based on Framingham Risk Score (FRS) and QRISK3 in different body mass index (BMI) groups.MethodsThis cross-sectional study was performed based on Shiraz University of Medical Sciences Employees Health Cohort Study (SUMS EHCS) data in April 2020. A total of 764 participants met the inclusion criteria. An expert performed demographic, anthropometric, and dietary evaluations. A semi-quantitative food frequency questionnaire (FFQ) was applied to assess the diet quality, and FRS and QRISK3 were used to evaluate the 10-year risk of CVDs.ResultsBased on the results, many components of HEI-2015 indicated an increasing trend through quartiles (p< 0.001). However, the consumption of refined grains in higher quartiles showed a decreasing trend (p< 0.001). The consumption of added sugar and saturated fatty acids (SFAs) in higher quartiles revealed an increasing trend (p< 0.001). In addition, lower HEI-2015 scores and lower whole grain consumption were significantly associated with higher BMI (p< 0.05). Also, lower consumption of fruits showed a significant relationship with higher risk scores of Framingham and QRISK3 (p< 0.05). Higher added sugar and SFAs intake was significantly related to lower FRS (p< 0.05). A significant reverse association between HEI-2015 and QRISK3 and Framingham risk scores was seen (p< 0.05).ConclusionOur findings support dietary recommendations to increase fruit and whole grains intake to prevent CVD and obesity. Moreover, a significant inverse association between HEI-2015 and QRISK3 and Framingham risk scores was observed. Since the results for added sugars and SFA intakes were controversial, further studies are needed.