Trump un­der­goes his first phys­i­cal exam as pres­i­dent

The Washington Post - - POLITICS & THE NATION - BY JENNA JOHN­SON AND LENNY BERN­STEIN jenna.john­son@wash­post.com leonard.bern­stein@wash­post.com

Pres­i­dent Trump’s per­sonal physi­cian once claimed that he would be “the health­i­est in­di­vid­ual ever elected to the pres­i­dency,” but there’s a good deal of ev­i­dence cast­ing doubt on that as­ser­tion.

Trump, who un­der­went his first pres­i­den­tial phys­i­cal exam Fri­day af­ter­noon, is older than all pre­vi­ous pres­i­dents when they first took of­fice. He is also the heav­i­est pres­i­dent in at least a gen­er­a­tion and con­sumes a diet heavy with Big Macs, Filet-O-Fish sand­wiches, fried chicken, pizza, well-done steak and two rounds of dessert. He seems to get lit­tle ex­er­cise be­yond swing­ing a golf club, as he spends most of his time on the course trav­el­ing in an elec­tric cart. And he likes to brag about how lit­tle sleep he gets.

The risks of such a health pro­file are well known: heart dis­ease, strokes, di­a­betes and high blood pres­sure, to name a few.

“He doesn’t look healthy,” said Daryl Isaacs, a New York in­ternist at NYU Lan­gone Health, who mon­i­tored the im­pact of Mor­gan Spur­lock’s month-long McDon­ald’s-only diet for the 2004 doc­u­men­tary “Su­per Size Me” and is one of the few med­i­cal ex­perts will­ing to ven­ture an opin­ion about the pres­i­dent. “His com­plex­ion doesn’t look healthy.”

Trump’s phys­i­cal exam was con­ducted at Wal­ter Reed Na­tional Mil­i­tary Med­i­cal Cen­ter un­der the su­per­vi­sion of Navy Rear Adm. Ronny L. Jack­son, who has been the lead White House doc­tor since 2013 and over­saw two of Pres­i­dent Barack Obama’s ex­ams. Trump, 71, ar­rived at Wal­ter Reed just be­fore 1 p.m. and left shortly af­ter 4 p.m.

“The Pres­i­dent’s phys­i­cal exam to­day at Wal­ter Reed Na­tional Mil­i­tary Med­i­cal Cen­ter went ex­cep­tion­ally well,” Jack­son said in a White House state­ment, which at first mis­spelled his given name. “The Pres­i­dent is in ex­cel­lent health and I look for­ward to brief­ing some of the de­tails on Tues­day.”

White House press sec­re­tary Sarah Huck­abee Sanders said Thurs­day that Jack­son would com­pile de­tailed re­sults over the long week­end and ap­pear at Tues­day’s press brief­ing to take ques­tions. Un­der­go­ing this phys­i­cal is vol­un­tary, and Trump can pick and choose what the pub­lic hears about his health.

Sanders an­nounced the exam in early De­cem­ber, a day af­ter the pres­i­dent gave a speech an­nounc­ing his plans to rec­og­nize Jerusalem as Is­rael’s cap­i­tal and, at one point, heav­ily slurred his words. At the time, Sanders said that the pres­i­dent’s throat was sim­ply dry, and she said this week that the exam had been in the works be­fore that in­ci­dent.

The exam would not in­clude a psy­cho­log­i­cal test, a White House spokesman said be­fore­hand, and of­fi­cials would not say whether Trump would un­dergo cog­ni­tive tests. Trump’s men­tal fit­ness has come un­der scru­tiny af­ter the re­lease of a book that por­trayed him as un­pre­pared for the pres­i­dency, in­ca­pable of pro­cess­ing in­for­ma­tion and un­in­ter­ested in mak­ing dif­fi­cult de­ci­sions.

The phys­i­cal-exam re­sults dis­closed by pre­vi­ous pres­i­dents have var­ied. Obama, Ge­orge W. Bush and Bill Clin­ton all re­leased their heights and weights, lists of the med­i­ca­tions they took, choles­terol lev­els, blood pres­sure and other lab re­sults.

Obama’s re­ports were usu­ally two pages with de­tails about his on-again-off-again re­la­tion­ship with smok­ing (“smok­ing ces­sa­tion ef­forts” in 2010, “to­bacco free” in 2011 and “re­mains to­bacco free” in 2014 and 2016). Bush’s re­sults of­ten filled more than four pages, even dis­clos­ing his body-fat per­cent­age. Clin­ton’s doc­tor ac­knowl­edged his strug­gles to stay healthy amid the stress of the pres­i­dency and cam­paign­ing, and the 6-foot-2 pres­i­dent weighed 214 pounds at his last exam in 2001.

Trump said in 2016 that he was 6-foot-3 and 236 pounds, which the med­i­cal com­mu­nity con­sid­ers over­weight; if he were 6-foot-2, as listed on his New York driver’s li­cense, he would be con­sid­ered obese. At the time, Trump ac­knowl­edged that he needed to lose 15 to 20 pounds. Since his in­au­gu­ra­tion, Trump ap­pears to have gained weight.

The Fri­day exam could of­fer great in­sight into Trump’s health — or at least pro­vide a ver­i­fied assess­ment of his height and weight. Dur­ing the cam­paign, Trump re­leased two one-page let­ters from his per­sonal physi­cian in New York, Harold N. Born­stein, that showed his choles­terol lev­els were con­trolled with med­i­ca­tion and were within the healthy range for a man his age. At the time, Trump’s blood pres­sure was 116/70, and his blood sugar was 99, both of which are nor­mal. Born­stein said other tests — an EKG and chest X-ray in April 2016, a transtho­racic echocar­dio­gram, or ul­tra­sound of the heart, in De­cem­ber 2014 and a colonoscopy in July 2013 — were all nor­mal.

Born­stein wrote that Trump takes just two med­i­ca­tions: a small dose of as­pirin and a statin to lower his choles­terol. Born­stein said in an in­ter­view with the New York Times last year that Trump had also taken a prostate-re­lated drug that can pro­mote hair growth and an an­tibi­otic to con­trol rosacea, a com­mon skin prob­lem.

In dis­cussing his health, Trump usu­ally points to the longevity of his par­ents: His mother was 88 when she died, and his fa­ther died at 93 af­ter suf­fer­ing from Alzheimer’s dis­ease for about five years.

“I con­sider my health, stamina and strength one of my great­est as­sets,” Trump tweeted in De­cem­ber 2015. “The world has watched me for many years and can so tes­tify — great genes!”

Trump has other fac­tors work­ing in his fa­vor: He grew up in a wealthy fam­ily and had ac­cess to qual­ity health care. He says he has never drunk al­co­hol or smoked. And he min­i­mizes his ac­cess to germs, even avoid­ing hand­shakes.

“It’s a med­i­cal fact that this is how germs are spread,” Trump wrote in his 2004 book, “How to Get Rich.” “I wish we could fol­low the Ja­panese cus­tom of bow­ing in­stead.”

Trump an­swered ques­tions about his health dur­ing a Septem­ber 2016 in­ter­view with the tele­vi­sion per­son­al­ity Mehmet Oz. Trump said he had not been sick in years — “Peo­ple are amazed be­cause I don’t get much with the colds” — and felt like he was still 35 years old. Trump said that his pri­mary form of ex­er­cise at the time was giv­ing rally speeches.

“I’m up there us­ing a lot of mo­tion — I guess in its own way, it’s a pretty healthy act,” Trump said. “A lot of times, th­ese rooms are very hot, like saunas, and I guess that is a form of ex­er­cise.”

Since the elec­tion, Trump has golfed sev­eral times a month, al­though he rides in a golf cart as much as pos­si­ble. Dur­ing a photo shoot with fel­low world lead­ers in Italy last sum­mer, Trump was trans­ported in a golf cart up a small hill while ev­ery­one else walked.

The pres­i­dent once ex­plained that he be­lieves “the hu­man body was like a bat­tery, with a fi­nite amount of en­ergy, which ex­er­cise only de­pleted” — a the­ory re­futed by doc­tors and phys­i­cal train­ers.

Later in the in­ter­view, Trump said he had long strug­gled with his weight and hoped to lose 15 or 20 pounds, al­though “it’s tough be­cause of the way I live.” A re­cent book by for­mer cam­paign man­ager Corey Le­wandowski and for­mer aide David Bossie, “Let Trump Be Trump,” said the pres­i­den­tial can­di­date would of­ten eat one McDon­ald’s meal a day con­sist­ing of two Big Macs, two Filet-O-Fish sand­wiches and a choco­late shake — a menu that would to­tal at least 2,400 calo­ries and more than 3,400 mil­ligrams of sodium.

Heavy bursts of fast food are not part of most doc­tor-rec­om­mended eating plans. Dur­ing the film­ing of “Su­per Size Me,” Isaacs said the doc­u­men­tary’s pro­tag­o­nist gained 24 pounds in a month, had in­creased choles­terol and other health prob­lems, and quickly de­vel­oped “fatty liver” be­cause the or­gan could not han­dle the con­sump­tion of a heav­ily caloric meal in a short pe­riod of time.

Med­i­cal ex­perts in­ter­viewed by The Wash­ing­ton Post were re­luc­tant to com­ment specif­i­cally about Trump be­cause they do not have ac­cess to all the rel­e­vant in­for­ma­tion about his health pro­file. But all said the diet and ex­er­cise reg­i­men he has ac­knowl­edged fol­low­ing di­verges widely from the guide­lines they pro­vide their pa­tients.

They rec­om­mend a diet heavy in fruits, veg­eta­bles and low-fat pro­tein such as chicken and fish, with small amounts of sugar and salt. The diet should be cou­pled with at least 150 min­utes of ex­er­cise per week, ide­ally spread over four or five ses­sions.

“There’s no age where it’s safe” to fol­low an un­healthy diet and ex­er­cise reg­i­men, said Alan Braver­man, a car­di­ol­o­gist and pro­fes­sor of medicine at the Wash­ing­ton Univer­sity School of Medicine in St. Louis. “You can’t start too early, and it’s re­ally a life­time rec­om­men­da­tion.”

Ex­perts cau­tioned that age it­self is a sig­nif­i­cant risk fac­tor. Al­though peo­ple age dif­fer­ently, in gen­eral, pa­tients in their early 70s can­not treat their bod­ies the way they did decades ear­lier and hope to re­main healthy.

“Ag­ing puts a dent in our phys­i­ol­ogy, our abil­ity to lose weight, our ex­er­cise ca­pac­ity,” said Ranit Mishori, a pro­fes­sor of fam­ily medicine at the Ge­orge­town Univer­sity School of Medicine. “That’s just nat­u­ral.”

Trump’s in­ter­view with Oz in 2016 came amid con­cerns about the health of his Demo­cratic op­po­nent, Hil­lary Clin­ton. Trump had glee­fully seized on the is­sue and once im­i­tated Clin­ton stum­bling while fall­ing ill at a 9/11 me­mo­rial event.

“I think you have an obli­ga­tion to be healthy,” Trump said. “I just don’t think you can do the work if you’re not healthy. I don’t think you can rep­re­sent the coun­try prop­erly if you’re not a healthy per­son.”

CHIP SOMODEVILLA/POOL/EPA-EFE/SHUTTERSTOCK

Navy Rear Adm. Ronny L. Jack­son gives a thumbs-up Fri­day af­ter su­per­vis­ing Pres­i­dent Trump’s phys­i­cal exam at Wal­ter Reed Na­tional Mil­i­tary Med­i­cal Cen­ter in Bethesda.

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