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Trump's doctor says he's in 'excellent health,' but the numbers tell a different story

Among President Donald Trump's risk areas are his heart health, cholesterol levels, and weight, experts say.

  • The White House physician Ronny Jackson on Tuesday said President Donald Trump was in "excellent health."
  • But details from Trump's physical, as well as input from experts, tell a different story.
  • Among the risk areas for Trump are his heart health, cholesterol levels, and weight.
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The White House doctor Ronny Jackson said at a Tuesday press conference that President Donald Trump was in "excellent health." But some of the numbers and statistics from Trump's physical exam that he cited tell a different story.

Among the risk areas are Trump's heart health, cholesterol levels, and weight, according to experts and information Jackson shared on Tuesday.

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Jackson said Trump's overall health — especially his heart health — was very good.

"The one thing that stands out more than anything to me is his cardiac health," Jackson said. "He doesn't have a lot of the traditional risk factors, things like a history of heart attack."

But Trump is taking 10 milligrams of Crestor (the brand name for a group of cholesterol-lowering drugs called statins) and aspirin, which has been found to reduce cholesterol and help lower the risk of a heart attack.

Jackson said he was looking into increasing Trump's dose of Crestor, but he didn't specify by how much.

Statins typically are recommended for older adults with high cholesterol or at risk of heart attack, stroke, or heart disease. People who have heart disease are almost universally prescribed statins, according to the US Preventive Services Task Force.

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The more obvious reason for Trump's use of Crestor is his cholesterol. Trump's level of LDL, or "bad," cholesterol is 143 milligrams per deciliter; the Centers for Disease Control and Prevention considers a level lower than 100 mg/dL healthy.

Trump's diet — which reportedly includes fast food, comfort dishes like meatloaf and spaghetti, and sweet treats like See's Candies and ice cream — probably doesn't help.

While the president, who turned 71 in June, takes a daily low dose of aspirin, there's still not enough evidence to say whether people over 70 who have not had a heart attack or stroke should take the medication, according to the US Preventive Services Task Force.

Jackson said Trump weighed 239 pounds, putting him on the border of what's considered obese for his height of 6-foot-3, based on a rough calculation known as body mass index, or BMI.

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BMI isn't perfect. Among its many pitfalls, the index fails to account for fat carried around a person's abdomen, an important measure of health. Instead, it measures only the ratio of someone's height to their weight, which is why some lean people with large amounts of muscle can have a BMI that would qualify as overweight.

But Jackson failed to take Trump's waist measurement, a simple metric that physicians are increasingly recognizing is a key measure of health — though he did mention plans to help improve the president's diet and institute an exercise program.

"There's not a lot of point in doing waist measurements," Jackson said on Tuesday.

Several studies have documented a link between high amounts of abdominal fat and an increased risk of heart disease and diabetes. In a 2012 study, researchers looked at data from more than 340,000 Europeans and found that people who were overweight and had large waists — 34.5 inches or more for women and 40 inches or more for men — had nearly the same risk of developing Type 2 diabetes as people who were clinically obese.

Scientists still aren't sure why excess fat around our middle appears to be so strongly linked to negative health outcomes, but they think it has to do with how fat inside the body, known as visceral fat, may interfere with the normal functioning of internal organs. It's something public-health experts have been studying for years.

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Numerous experts have questioned Trump's mental health, including some who have called his public tweets — including a recent one in which he teased North Korean leader Kim Jong Un about the size of his nuclear button — threatening.

Typically, psychiatrists are barred from commenting publicly on the mental state of presidents because of the Goldwater rule, a reference to a section of the American Psychiatric Association's Principles of Medical Ethics that says psychiatrists should not give a professional opinion about public figures whom they have not examined directly.

But in July, the American Psychoanalytic Association defied that rule and said its members could publicly discuss Trump's mental health.

"We don't want to prohibit our members from using their knowledge responsibly," Prudence Gourguechon, a past president of the association, told the Stat News reporter Sharon Begley.

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On Tuesday, seemingly in response some of those concerns, Jackson said Trump got a perfect score on a 10-minute cognitive-health screening.

Jackson said Trump, who earlier this month on Twitter declared himself a "stable genius," had requested the test.

But the test is not a comprehensive exam of mental acuity — it requires patients to perform simple tasks like drawing a clock, identifying some pictures of animals, and repeating words and phrases correctly. It is designed to test for signs of cognitive decline in older adults, not for lifelong issues.

"The test is a screening measure," Ziad Nasreddine, the Canadian neurologist who designed the test, told The Canadian Press. "It has limitations."

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