He now holds likely the most stressful job in the world, one he said was harder than he thought it would be, leading medical and health experts to wonder how, when or if President Trump's lack of exercise, sleep, eating habits and stress will catch up to him.
As it is with virtually everything the 45th president does, analyzing Trump's health has spawned diverse opinions, ranging from his personal physician's five-minute analysis of Trump's "astonishingly excellent" health to a cardiologist's assessment that Trump's ability to father a child 12 years ago "speaks to a degree of virility that many men wish they could emulate."
The 71-year-old president, who according to information his campaign provided last year to the Dr. Oz show, is 6 feet,3 inches tall and weighs at least 236 pounds, which is overweight.
Stress is likely what ages presidents the most, says physician Anupam Jena, a Harvard Medical School health care policy professor and author of a study of politicians' mortality rates. And along with the usual challenges of the job, after six months in office, "Trump has got an awful lot of stress with whatever’s going to happen with the Russian probe," says Jena.
The 2015 study Jena led looked at the mortality rates of politicians from around the world and found their life expectancy was 2.7 years shorter than those they lost to. Jena says that comparison is better than with the general population as political leaders have been from a different socioeconomic class as the rest of society as far back as 1900.
Jena, an internal medicine doctor, says healthy eating, increased exercise and a good night's sleep are the key ways political leaders can offset their risk of earlier death.
Those who know Trump, including physicians, say they aren't worried about him.
"The guy is not a health nut, but he's always in motion," says Chris Ruddy, the CEO of the media company Newsmax, who has known Trump for 20 years.
Ruddy says Trump will often chide him if he "needs to lose a few pounds," and is always monitoring his own weight.
After he was the target of jokes for eating pizza with a fork in 2011, Trump released a video response quoted by Time, that explained he could more easily eat just the cheese if he used utensils.
"I like to not eat the crust so we can keep the weight down at least as good as possible," he said.
Washington cardiologist Ramin Oskoui also advised Trump on health care policy during the campaign and reviewed Trump's medical information last year. He says it "seemed fairly reassuring. He has high cholesterol and was taking appropriate medication."
"He seems to have gotten good care and followed the recommendations of his Internist," Oskoui said in an email. "While the records were brief, they were pretty reasonably straight forward and transparent. I wouldn't say the same thing about [Democratic nominee Hillary] Clinton. "
Harold Bornstein, Trump's doctor until he started using White House physician Ronny Jackson this year, said he wrote Trump's health report in five minutes and used the president’s “kind of language.”
Even if Bornstein was embellishing to the degree his patient prefers, medical experts consulted by USA TODAY say Trump's approach to food and fitness are frightening for 71-year-old man under his amount of stress.
"Do I worry he’s going to have a heart attack or stroke in office?" asks Cleveland Clinic physician and diet book author Michael Roizen, "From a medical standpoint, you would worry about that."
USA TODAY reported recently that neurologists say Trump shows most symptoms of sleep deprivation — including diminished cognition and anxiety — and a June report shows exercise is the single best medicine for a good night’s sleep.
But Trump believes everyone has a finite amount of energy to use throughout his or her lifetime, so he doesn't exercise beyond playing golf while riding a cart. He is best known as a fan of fast food, which he has discussed often in media interviews, or higher-end burgers at his country clubs, which Ruddy confirms.
Regardless of her patients’ sleep problems, Maryland sleep medicine doctor and neurologist Helene Emsellem says appointments “invariably include a discussion of diet and exercise" as they try to solve them.
Despite its sleep-inducing qualities, Trump publicly eschews exercise.
Told of Trump's belief exercise uses up the body's finite energy, Roizen had a good long laugh. "Oh God," said the Cleveland Clinic's chief wellness officer.
It leads to other problems too, Trump believes.
‘‘All my friends who work out all the time, they’re going for knee replacements, hip replacements — they’re a disaster,’’ Trump said in a September 2015 New York Times Magazine article.
Former House Speaker Newt Gingrich, who is an informal adviser to the president, finds Trump's aversion to actual exercise irrelevant.
"Donald Trump is one of the those people who is genetically disposed to have high energy," says Gingrich, who has a Ph.D. in history, not medicine.
Besides, the president "golfs constantly" at such a rapid clip that it's a form of exercise, says Gingrich. That's despite the fact he uses a cart rather than walks the course.
Golfing also keeps him from eating. Ruddy says Trump once told him: "You'll love golf — four hours when you're not eating or thinking about food."
Playing golf while riding a cart 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.
Golf = one piece of KFC
That's about the same calories in one extra crispy Kentucky Fried Chicken breast. It's also just under what Trump burns with three hours of sleep, says neurologist William Winter, author of The Sleep Solution.
"For Trump, his lack of sleep can create problems with his weight" and metabolism, says Winter. Sleep deprivation suppresses the chemical leptin, which makes us feel full.
"This will have the effect of making POTUS eat more to feel full," says Winter.
It also leads to an overproduction of the chemical ghrelin, which makes people crave bad foods, such as those with a lot of sugar and fat for quick energy, Winter says. And along with affecting insulin levels that can trigger the body to store fat, Winter says sleep deprivation makes you sleepy and less likely to exercise.
That's if you were inclined in the first place.
The White House doesn't comment on how often Trump golfs. Politifact, which has been tracking Trump's golf through public sightings and other reports, says the president has golfed 19 times between his inauguration and July 5. (The site also compares Trump to former President Barack Obama, who golfed eight times at this point in his presidency. During the presidential campaign, Obama was roundly criticized by Trump for golfing too much.)
"If you look at the data on exercise and health. there is a clear relationship," says Roizen, co-author of the new book AgeProof. "It makes you have less disability and lowers your risk of all-cause mortality, of cancer and of brain dysfunction."
The Department of Health and Human Services and its President’s Council on Fitness, Sports and Nutrition recommends 150 minutes of moderate aerobic activity, 75 minutes of vigorous aerobic activity, or a combination of the two every week.
But that predated Trump’s administration, which has allowed the President’s Council to languish. “To be announced” is all the site says under members and leadership. Former California governor, Mr. Universe and recent Trump nemesis Arnold Schwarzenegger is an ex-chairman of the council.
Conversely, President George W. Bush, who WebMD called “President Buff,” used the elliptical machine two days, lifted weights two days, ran four miles four days and did “lots of stretching" in a typical week, according to information released by the White House during his administration. He was also an avid cyclist.
Obama worked out for about 45 minutes for six days a week, alternating between cardio-strength training and weightlifting, according to Men's Health which dubbed him one of their "Heroes of Health and Fitness" in 2015.
Diet and exercise were also former first lady Michelle Obama's signature issues. As the fitness council lay dormant, Trump's Agriculture Secretary Sonny Perdue relaxed the nutritional standards for school lunches and delayed deadlines for adherence, notes nutrition expert and author Marion Nestle, a New York University professor.
"One of the things Michelle Obama did was exert an enormous moral force for keeping kids healthy," says Nestle. "These things have to be changed at societal level and it’s really nice if you have a government that promotes it. At the moment we don’t, alas."
While he was president, Bill Clinton came the closest to what Gingrich calls Trump's "middle American eating habits." Like Trump, Clinton also didn't drink alcohol.
Clinton, however, "ran with the Secret Service agents five days a week," says Roizen.
At 71, Trump is also considerably older than his predecessors, but that doesn't mean he is supposed to exercise any less. It does mean he's in step with other 70-somethings. Roizen says less than 1% of adults aged 65 do the basic level of recommended exercise, which includes cardio, resistance training and walking about 10,000 steps a day.
By all accounts, Trump is six feet, three inches tall. His weight is 236 or 267 — or somewhere in between — depending on which account by Dr. Oz, other reports (or golf course photo) you believe.
The data submitted to the Dr. Oz Show said he was 236 pounds, which would make him "overweight but not obese," says Roizen but he believes he was — and is — "much bigger." His other health measures were "remarkably normal and as close to ideal as you can get."
"I found it surprising because he doesn’t look like the lab data would be normal," says Roizen. "His food habits, exercise habits and sleep habits didn’t seem to reflect normal lab data."
Trump has talked often of his love of fast food. Gingrich reiterated what has been written in the past about Trump's attraction to both fast food and hygiene.
"It’s definable," Gingrich says of fast food. "He's looking for consistency and reliability."
As Roizen notes, "Knowing what’s in it and being healthy for the body are two different things."
Trump and now-First Lady Melania Trump appeared on a video on Martha Stewart's website in 2006 as Stewart prepared "Donald's favorite sandwich" — meat loaf.
The food choices on Trump's campaign plane reported by the New York Times included chateaubriand, shrimp cocktail, chicken, sea bass and potatoes au gratin. Trump chose liberally from the potatoes and shrimp that day.
One of the few recent Trump meals journalists have reported on — a May 8 dinner attended by three Time correspondents — included two scoops of ice cream with pie for him, one for everyone else and a fruit plate for Vice President Pence. Trump also got an extra side of sauce for his chicken.
Bornstein answered his office phone when called by a reporter recently, but hung up when he learned it was about Trump. White House and former Trump campaign spokeswoman Hope Hicks declined to respond to questions about Trump's health, beyond sending the link to an article about the president now using the White House physician.
While many have noted Trump already looks like the presidency has taken a toll on him, Gingrich isn't one of them.
"I think he looks he’s having the time of his life," says Gingrich. "My hunch is it won’t age Donald Trump at all."
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