
WASHINGTON — President Obama “is in excellent health” and likely to remain able to carry out his duties for the rest of his term, his doctor said Sunday after completing Mr. Obama’s first routine medical checkup since he took office.
But Mr. Obama, 48, continues to struggle to stop his 30-year smoking habit and needs to modify his diet, said Dr. Jeffrey Kuhlman, a Navy captain who led the medical team that performed Mr. Obama’s physical.
The examination also found that Mr. Obama’s cholesterol count has risen to borderline high levels since his last publicly released medical records, though his pulse rate and blood pressure remain normal.
Mr. Obama exercises at least six mornings a week and plays basketball and golf. But the president has chronic tendinitis in his left knee area, occasionally takes a nonsteroidal anti-inflammatory drug for that condition and needs a modified exercise regimen, including a lower leg muscle strengthening program, Dr. Kuhlman’s report said.
Mr. Obama’s cholesterol increase comes at a time when his wife, Michelle, has started a program to fight childhood obesity.
Robert Gibbs, the White House press secretary, said Sunday that the increase was attributed to the president’s diet. While Mr. Obama often eats healthful meals prepared by the family’s chef, Sam Kass, he also takes advantage of around-the-clock food available to him during long workdays at the White House, Mr. Gibbs said.
“I think it’s a few more burgers and a few more desserts over the past year,” he said.
Cholesterol measurements can vary among laboratories. Presumably, Mr. Obama’s cholesterol has been tested at other times. But the findings and the laboratories that performed the tests are not publicly known. So it is possible that Mr. Obama’s cholesterol has fluctuated over recent years and represents such a variation.
Doctors see a rise in cholesterol like Mr. Obama’s occasionally, said Dr. Martin L. Kahn, a professor of cardiology at New York University who is not connected with Mr. Obama’s case. “Usually that is a lever for the doctor to recommend more aggressive dietary changes and cigarette cessation to warn a patient, ‘Look what you are doing to yourself’,’ “ Dr. Kahn said in an interview.
“Nutritionists tell us that a very little extra food each day adds up to a measurable amount at the end of a year,” Dr. Kahn said.
As for Mr. Obama’s smoking, Mr. Gibbs said the president had tried to quit, but had “admitted lapses.” It is not known how frequently Mr. Obama smokes, or what the figure is for his total “pack years,” a standard measure of a smoker’s risk for diseases like lung cancer.
Mr. Gibbs referred reporters to the president’s own words from last June, when he was asked about his smoking addiction while signing a law aimed at keeping children from starting to smoke. The president noted that 90 percent of smokers began on or before their 18th birthday.
“I know — I was one of those teenagers,” Mr. Obama said. “I know how difficult it can be to break this habit when it’s been with you for a long time.”
He added: “I would say that I am 95 percent cured, but there are times where I mess up.”
Mrs. Obama admonished him to quit smoking when he started his campaign in 2007, saying, “He couldn’t be a smoking president.”
Mr. Obama chews nicotine gum to cut down on his smoking.
“Have I fallen off the wagon sometimes? Yes,” Mr. Obama said last June at a White House news conference. “Am I a daily smoker, a constant smoker? No.”
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