A White House doctor pronounced President Trump medically fit to serve as commander-in-chief on Tuesday – and added that he easily passed a voluntary cognitive assessment designed to test his mental reflexes.
"The president's overall health is excellent," Dr. Ronny Jackson told reporters during an unusual briefing at the White House, days after completing the Trump's first physical examination as president.
Jackson did say that the 71-year-old, 239-pound president could use more exercise and a better diet that is lower in fat and carbohydrates. Trump, who is known to eat junk food and to avoid exercise beyond golf, is overweight. Jackson said they set a "reasonable goal" of losing 10 to 15 pounds in the coming year and developing a regular fitness routine.
"He’s more enthusiastic about the diet part than the exercise part," Jackson said.
Trump, who has gained three pounds since his physical in 2016, takes a drug to reduce his cholesterol, and Jackson said he may increase the dosage The doctor added that Trump does not use tobacco or alcohol, one of the reasons he is in good health generally.
The president's yearly physical at Walter Reed National Military Medical Center, which took place on Friday, is a routine practice. But Trump's exam has taken on heightened scrutiny amid questions about his mental fitness.
Jackson, a Navy rear admiral who wore his uniform to the White House press room, said it's the first time he knows of that a cognitive test has been given to a sitting president.
Critics began openly questioning Trump's mental heath this month following a tweet in which he said he has a bigger nuclear button than North Korea leader Kim Jong Un, and the publication of Fire and Fury, a book about the White House, in which anonymous Trump acquaintances questioned the president's mental stability.
Trump, earlier this month, pushed back over Twitter, insisting he is a "very stable genius" and that mental stability is one of his greatest assets.
Jackson said he “initially had no intention” of including a test of the president’s mental fitness in his first annual physical, and stressed that he had “absolutely no concerns about his cognitive ability or neurological functions." Such exams are not usually part of presidential physicals.
Still, at the president's request, Jackson did an assessment to screen for any cognitive impairment such as Alzheimers – and Trump got a perfect score.
"The president is mentally very sharp," Jackson said.
Diet and exercise
The president has a body mass index of 29.9 which places him in the overweight category on the verge of obesity, which is defined as a BMI of 30 or greater.
Trump, who has gained three pounds since his physical in 2016, takes a drug to reduce his cholesterol, and Jackson said he may increase the dosage. The doctor added that Trump does not use tobacco or alcohol, one of the reasons he is in good health generally.
Asked how Trump could stay healthy on a diet that includes McDonald's and Diet Cokes, Jackson said: "It's called genetics – I don't know."
While Trump's may be the dream diet of a teenage boy, it's a nightmare for those trying to model or message that healthy eating — and exercise — are the key to good health. And that is something Jackson is going to work with him to change.
"There are 'good' genes, but what research has shown us is that more than genes, more than health care, more than social circumstances, behaviors are the leading cause of premature death," says Bernadette Melnyk, a professor and dean of Ohio State University's college of nursing and the university's chief wellness officer. "And there's good evidence behind that."
After all, one's genes can only do so much.
"Some gene variants are slightly more efficient at detoxifying harmful chemicals in the liver, which leads to a slightly decreased cancer risk," says Maureen Murphy, a cancer geneticist with the Wistar Institute in Philadelphia. "But I don’t think good genetics trumps — I mean beats — bad lifestyle."
Trump is well known for questioning whether exercise is beneficial and doesn't appear to get any beyond golfing with a cart.
This activity burns only about half as many calories than walking, or an average of 411 calories for nine holes, according to a study by Neal Wolkendoff of the Colorado Center for Health and Sport Science.
Even if Trump has enjoyed good health until his early 70s, that doesn't mean his lifestyle will lead to longevity.
"Luck is a huge part and it might not last," Murphy said.
A thorough briefing
Under repeated questioning at the White House that lasted an hour, Jackson said he had no concerns about Trump's physical, mental, or emotional ability to do the job.
Jackson said Trump encouraged him to speak with reporters about the physical, and to take every question they had.
According to Jackson, Trump told Press Secretary Sarah Sanders, "I do not want you pulling him off that stage."
Reporters peppered Jackson with questions about his tweeting and television-watching habits and how much sleep he gets a night. Jackson estimated that Trump only gets four to five hours of sleep a night. "He doesn't sleep much," he said.
Asked about the president's slurring of words during a recent speech, Jackson said there is no medical evidence of impaired vocal performance, and said it was probably just a dry throat.
"I think I need a drink of water," he joked.