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However, the effect of diet composition, specifically the role of protein intake on frailty, is mostly unclear. The aim of this study was to evaluate the intake of protein, including total, plant, animal, and dairy protein, in relation to frailty incidence in a large cohort of older women.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We analysed data from 85\u00a0871 women aged \u226560 participating in the Nurses' Health Study. Intake of protein was measured nine times during follow\u2010up from 1980 until 2010. Frailty was defined as having at least three of the following five criteria from the Fatigue, Resistance, Ambulation, Illnesses and Loss of Weight (FRAIL) scale: fatigue, low strength, reduced aerobic capacity, having \u22655 illnesses, and weight loss of \u22655%. The occurrence of frailty was assessed every 4\u00a0years from 1992 up to 2014.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>During follow\u2010up, we identified 13\u00a0279 incident cases of frailty. Women with a higher intake of plant protein had a lower risk of developing frailty after adjustment for all relevant confounders [relative risks across quintiles of consumption: 1.00, 0.94, 0.89, 0.86, and 0.86; <jats:italic>P<\/jats:italic>\u2010trend\u00a0&lt;\u00a00.001]. In contrast, those with a higher intake of animal protein intake had a higher risk of frailty [relative risks across quintiles of consumption: 1.00, 0.98, 0.99, 1.00, and 1.07; <jats:italic>P<\/jats:italic>\u2010trend 0.04]. The intake of total and dairy protein showed no significant association with frailty in the full model. Substituting 5% of energy from plant protein intake at the expense of animal protein, dairy protein, or non\u2010dairy animal protein was associated with 38% (29%, 47%), 32% (21%, 42%), and 42% (33%, 50%) reduced risk of frailty.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A higher intake of plant protein, but not animal or dairy protein, was associated with a lower risk of frailty. Substitution of plant protein for animal protein, especially non\u2010dairy animal protein, was associated with lower risk of frailty.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jcsm.12972","type":"journal-article","created":{"date-parts":[[2022,3,23]],"date-time":"2022-03-23T07:54:49Z","timestamp":1648022089000},"page":"1752-1761","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":58,"title":["Protein intake and risk of frailty among older women in the Nurses' Health Study"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9302-9616","authenticated-orcid":false,"given":"Ellen A.","family":"Struijk","sequence":"first","affiliation":[{"name":"Department of Preventive Medicine and Public Health, School of Medicine Universidad Aut\u00f3noma de Madrid\u2010IdiPaz  Madrid Spain"},{"name":"CIBERESP (CIBER of Epidemiology and Public Health)  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresa T.","family":"Fung","sequence":"additional","affiliation":[{"name":"Department of Nutrition Simmons University  Boston MA USA"},{"name":"Department of Nutrition Harvard T.H. Chan School of Public Health  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernando","family":"Rodr\u00edguez\u2010Artalejo","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine and Public Health, School of Medicine Universidad Aut\u00f3noma de Madrid\u2010IdiPaz  Madrid Spain"},{"name":"CIBERESP (CIBER of Epidemiology and Public Health)  Madrid Spain"},{"name":"IMDEA\/Food Institute, CEI UAM+CSIC  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heike A.","family":"Bischoff\u2010Ferrari","sequence":"additional","affiliation":[{"name":"Department of Geriatrics and Aging Research University Hospital Zurich and University of Zurich  Zurich Switzerland"},{"name":"Centre on Aging and Mobility University Hospital Zurich and Waid City Hospital  Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank B.","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Nutrition Harvard T.H. Chan School of Public Health  Boston MA USA"},{"name":"Channing Division of Network Medicine, Department of Medicine Brigham and Women's Hospital and Harvard Medical School  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walter C.","family":"Willett","sequence":"additional","affiliation":[{"name":"Department of Nutrition Harvard T.H. 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