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

• White House physician Ronny Jackson maintained that Trump was in "excellent health" on Tuesday.
• Details from his physical as well as input from experts tell a different story.
• Everything from Trump's mental acuity to his heart and weight may be at risk.

White House doctor Ronny Jackson maintained that President Trump is in "excellent health" at a Tuesday press conference in which he released some details from his physical exam, but other information that Jackson revealed - including some of the numbers and statistics he cited - tell a different story.

Everything from Trump's heart and cholesterol to his weight and mental acuity may be at risk, according to experts and information Jackson shared on Tuesday.

Trump's heart may be at risk

Jackson said Trump's overall health - especially his heart health - is 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."

Yet Trump is taking 10 milligrams of Crestor (the brand name for a larger group of cholesterol-lowering drugs called statins) and aspirin, which is known to help reduce the risk of heart attacks. Jackson said he is looking into increasing Trump's dose of Crestor, but didn't specify by how much.

Statins are typically recommended for older adults with a risk of heart attack, stroke, or heart disease. Such medications are almost universally prescribed to people who already have heart disease, according to the US Preventive Services Task Force.

The more obvious reason for Trump's use of Crestor, however, is his cholesterol. Trump's LDL cholesterol levels (also known as "bad" cholesterol) are 143 milligrams per deciliter, or 43 milligrams above what's considered healthy by the Centers for Disease Control and Prevention. 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 takes a daily low dose of aspirin, there's still not enough evidence to say if people over 70 who have not already had a heart attack or stroke should take the medication, according to the US Preventive Services Task Force (Trump turned 71 in June.)

Trump is teetering on obese

Also on Tuesday, Jackson revealed that Trump weighs 239 pounds, which puts him on the border of what's considered obese for his height based on a rough calculation known as the body mass index, or BMI.

But Jackson said he did not calculate Trump's BMI and had no plans to do so.

BMI isn't perfect. Among its many pitfalls, the BMI fails to account for a very important measure: fat carried around a person's abdomen. Instead, it only measures the ratio of someone's height and 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 measure Trump's waist. That's a simple metric that physicians are increasingly recognizing as a key measure of health.

"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 large 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.

Although Jackson did not account for Trump's waist measurement in his analysis, he did mention plans to help improve the president's diet and institute some kind of exercise program.

Trump's perfect score on a cognitive health exam doesn't tell the whole story

Trump's mental health has been questioned by countless experts who have called his public tweets - including a recent squabble 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 as a result of the Goldwater rule, a reference to a section of the American Psychiatric Association's Principles of Medical Ethics that states that psychiatrists should not give a professional opinion about public figures whom they have not examined directly.

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

The reasoning behind the change was a need to allow members to "use their knowledge responsibly," past association president Prudence Gourguechon told Stat News reporter Sharon Begley.

"Trump's behavior is so different from anything we've seen before" in a president, Gourguechon said.

On Tuesday in a seeming response to some of those concerns, Jackson revealed Trump's results on a 10-minute cognitive screening.

Jackson said that Trump, who earlier this month declared he was a "stable genius" on Twitter, had personally requested the test. Trump got a perfect score.

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. It has limitations," Ziad Nasreddine, the Canadian neurologist who designed the test, told the Canadian Press.

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