Objective To investigate the effect of Chinese dietary guidelines on carotid atherosclerosis and cardiovascular disease. Methods Quality Intima-Media Thickness (QIMT) were measured. The 10-year atherosclerotic cardiovascular disease (ASCVD) risk score were calculated by the Pooled Cohort Equations. Three groups were divided according the guidelines: low-intake group; normal-intake group; high-intake group. Explore the correlation between dietary components and carotid atherosclerosis. Logistic regression analysis was conducted to compare the risk of carotid atherosclerosis among the three groups. The relationship between different food intake and 10-year ASCVD risk scores was analyzed. Results The consumption of vegetables, fruits, dairy products were negatively correlated with carotid atherosclerosis. Meat and poultry were positively correlated with carotid atherosclerosis (all P<0.05). Insufficient intake of vegetables and fruits and high consumption of Meat and poultry increased the risk of carotid atherosclerosis (OR=1.93,2.03, 3.72, P<0.05). High intake of cereals, rice, meat and poultry and low intake of dairy were associated with an increased risk of ASCVD (all P<0.05). Conclusion insufficient intake of vegetables and fruits and high consumption of cereals, rice, meat and poultry may increase the risk of cardiovascular disease.