Our President’s Personal Health Matters
voting US citizens will have to weigh the strengths and
weaknesses of John McCain and Barack Obama when voting
November 4, 2008 to choose the President of the United
States. The personal health of these two candidates will
play a determining role in their performance over the next
four to eight years. This grueling job requires the highest
level of physical and mental fitness. A serious disability
or the death of our national leader during office would
disrupt the function of our government and require the
vice-president to take office.
president’s personal health will affect his (or her)
policies and decisions. Our views are biased by our own
personal habits. More to the point, people have a hard time
seeing beyond their own dinner plates. A president
interested and knowledgeable about good diet and exercise
habits, not only incorporates this wisdom into his own life,
but will also share this understanding with others. The
impact will be as far reaching as national healthcare
(health insurance), the USDA, the FDA, the EPA, the diet of
the military, the school lunch programs, the pharmaceutical
industry, the global impact of livestock on the environment,
health education, and your own personal doctors’ practice of
the above reasons you need to be well aware of, and take
into serious consideration, the personal health and health
habits of McCain and Obama when you cast your vote.
it to be my obligation to my newsletter subscribers, and
especially to my patients, to share with you the facts that
I have gathered about our candidates and my opinion as to
how their health and habits may affect their ability to
serve you and the rest of our nation.
Candidates’ Personal Heath Habits
February 25, 2008 the New Yorker magazine describes
John McCain's campaign bus as “stocked with Dunkin’ Donuts
and Coke, the staples of the McCain diet.” He grabs a candy
bar or a bag of potato chips while he engages reporters for
interviews. The Senator has been said to have a weakness for
Butterfinger candy bars, jellybeans, coffee, and doughnuts.
Most candidates gain weight on the campaign trail, however,
Obama has lost about 5 pounds, following what he believes to
be a healthy diet of salmon and broccoli.
hikes whenever he can find the time and walked the Grand
Canyon rim to rim in August 2006. He is limited by his
post-traumatic (brought on by war injuries) degenerative
arthritis affecting especially his hands and shoulders.
plays pickup basketball, runs three miles, and exercises at
hotel gyms with lightweights and treadmills daily.
Cigarette Smoking History:
smoked two packs of cigarettes a day for 25 years before
quitting in 1980.
has quit smoking on several occasions and currently uses
Nicorette gum with success. He promises his wife, Michelle,
he will give up smoking.
personal diet and exercise regime, and his personal
appearance of robust health provide a positive image for a
president. Based on these observations I believe he is much
more likely to make decisions and take actions that will
result in better health and healthcare for the average
American than is McCain.
Based on Age Alone
72. Date of Birth: August 29, 1936
Date of Birth: August 4, 1961
Based solely on their age, and no other health issues,
McCain’s life expectancy is 12 years and Obama’s is 31
years.1 Over the next 4 years a man of 72 years
has a probability of dying of 16% and over 8 years, 38%. At
age 47 a man has a 2% probability of dying of within 4
years, and 5% within 8 years.
“golden” years a person also has a significant risk of
becoming disabled from a variety of conditions, including
stroke, dementia, Alzheimer's Disease, heart attack, cancer,
and arthritis. After age 70, the risks of all these
disabilities increase rapidly with each passing month and
are related to the quality of a person’s diet and lifestyle.
Past and Present Medical History
allowed a select group of 20 reporters to view for only 3
hours his 1,173 pages of medical records on May 23, 2008,
and these records were in addition to 1,500 pages
distributed the last time he ran for the Republican
candidate for president in 2000.
one page medical letter on Obama's most recent medical
checkup, done on Jan. 15, 2007, gave him a report of
Future history almost always follows past history when it
comes to health. The exception is seen when people make
serious changes in their diet and lifestyle; not by taking
more medications. McCain appears to be unaware of the
importance of a healthy diet.
by the Candidates
statin for lowering cholesterol.
diuretic commonly prescribed for hypertension.
Also rarely prescribed for kidney stone
prevention; he has small stones in his right
potassium-sparing diuretic used to treat
prescribed for prevention of heart attacks and
other blood clots.
anti-histamine, used as necessary for nasal
sleeping pill, used as necessary for sleep
A multiple vitamin tablet
Candidates’ Heart Disease Risk
Framingham CHD Score = 27%
Framingham CHD Score = 3% as a smoker and 1% as a
Framingham Heart Disease Risk Calculator combines several
risk factors in order to give a score, as a percentage, that
represents the probability of having a coronary heart
disease (CHD) event within 10 years.2
Weight: 163 to 168 pounds
Height: 5 feet, 7 inches
Cholesterol: 226 mg/dL (before
Cholesterol: 192 (on simvastatin*)
HDL cholesterol: 35 mg/dL (before
Triglycerides: 260 mg/dL (before
Triglycerides: 135 mg/dL (on
Blood pressure: 134/84 mmHg (on
two anti-hypertension medications)
Blood Sugar: 111 mg/dL (slightly
elevated above ideal)
Weight: trim (no excess fat)
Height: 6 feet, 1 inch
Cholesterol: 173 mg/dL (no
HDL cholesterol: 68 mg/dL (no
Triglycerides: 44 mg/dL (no
Blood pressure: 90/60 mmHg (no
For people without a solid
previous history of previous heart disease or
stroke, therapy with statins has been shown to
cause little or no reduction in their risk of
future cardiovascular disease.3
The Framingham Heart Disease Risk Calculator gives McCain a
27% chance of having a coronary heart disease (CHD) event,
such as a heart attack, heart surgery, and/or death within
10 years.2 His slightly elevated blood sugar and
moderately elevated body weight push this risk even higher.
A heart attack or surgery (angioplasty or bypass) would at a
minimum put the vice president in charge for weeks to months
during his recovery.
encourage McCain to change to the McDougall diet, since his
excess weight, kidney stones, and elevated cholesterol,
triglycerides, sugar, and blood pressure are due to his
unhealthy eating. My recommendations to Obama: quit smoking
by the only method that works, which is to refuse the next
cigarette. He should also learn that fish is not health
food, at least for the sake of our dying oceans.
Significance of McCain’s Melanomas
is a serious, and often fatal, form of skin cancer. His
first bout with this disease came in 1996 after the biopsy
of a lesion on his left temple, which showed atypical
junctional melanotic proliferation. In 2000 a lesion in the
same area was diagnosed as invasive melanoma (Stage IIA
melanoma). Actually, at this time there were two areas of
melanoma, believed to have arisen separately, found. One
reached to a depth of l.23 mm and the other had a thickness
of 2.2 mm. These two cancers are believed to have formed
from the spread of the 1996 lesion by way of the veins
located in McCain’s left temple area; a process known as
finding of “negative” lymph nodes during McCain’s surgery of
2000 suggests the disease was in early stages, 8 years ago.
Spread of cancer to the lymph nodes is an independent
process that simply indicates that the disease is in the
later stages of development. Invasive melanoma spreads very
early by way of the veins, not by the lymph nodes, to the
rest of the body. It is important to understand that the
finding of negative lymph nodes does not mean that the
cancer has not spread.5 In fact, the presence of
the two satellite metastases treated in 2000 confirms that
spread had already occurred through his veins more than 12
years ago, and is evidence that melanoma cancer cells are
almost certainly present in other parts of the Senator’s
circular mass of skin and flesh, 6 centimeters in diameter,
was removed from the left side of the McCain's face, along
with the underlying parotid salivary gland. This aggressive
operation seems to have controlled the “local disease.”
study of a large numbers of patients (17,600) with melanoma
has validated the American Joint Committee on Cancer
melanoma staging system.6 This staging system
predicts a 64% chance of a patient with stage IIA melanoma
surviving for 10 years.7 For someone in McCain’s
age group the prognosis drops to 56%.6 McCain is
already 8 years into these 10-year figures, which does not
mean that he has beaten the odds.5 Rather,
because this is an on-growing systemic disease, unaffected
by the extent of local facial surgery performed on the
Senator in 2000, risk of death from his original melanoma
will continue every year, long past the 10-year benchmarks
had 3 other superficial melanomas—on his left shoulder, left
arm, and left nasal sidewall. His approach to these
potentially deadly skin cancers has been avoidance of
sunlight exposure. This effort will be of little avail
because melanomas are not due to photo-damage.8-10
Rather, this serious cancer, like so many others, is due, at
least in part, to his unhealthy diet.11-13 This
same junk-food diet promotes the growth of cancer cells
already present in his body and will likely shorten the
Senator’s life. Here is one more reason I would strongly
encourage McCain to change to the McDougall diet.
his presidency melanoma were to be found to have spread to
his liver, brain, lungs, and/or bones, then chemotherapy
treatments would undoubtedly be recommended. However, these
toxic chemicals would cause him to become disabled, unable
to perform his duties, for the few short months he would
Be Kidding Yourself If You Are in Doubt
is impossible to predict with certainty any person's future
health, time of death, or degree of disability, the evidence
at hand clearly says John McCain is in relatively poor
health and Barack Obama is in excellent health. All politics
aside, no one could conclude otherwise. To McCain’s credit
he appears to be holding up well during this grueling
campaign, but his current appearances do not negate the
Additionally, although it is impossible to accurately merge
all the figures that predict mortality—38% (actuarial
figures), 27% (cardiac risk), and 44% (melanoma
mortality)—it would not be unreasonable to guess that
McCain’s chances of dying within the two terms of
Presidential office far exceed a coin toss. Add to this the
risk of him becoming disabled to the point of
non-performance, then who among well-informed voters would
bet their stock portfolio or their subprime-mortgaged home
that, if elected, McCain will still be our President come
2017? Would you, or the company you work for, hire an
employee with McCain’s medical problems? How about someone
with Obama’s health history? Of course, there are many
other important issues that will determine the vote you will
cast come November 4, 2008, but the health of our candidates
is of paramount importance and should be weighed
Actuarial tables: http://www.cdc.gov/nchs/data/statab/lewk3_2003.pdf
Framingham Heart Disease Risk Calculator:
Abramson J, Wright JM. Are lipid-lowering guidelines
evidence-based? Lancet. 2007 Jan 20;369(9557):168-9.
Satellite Melanoma: http://i.usatoday.net/news/mmemmottpdf/mccain-health-pool-2-5-23-2008.pdf
Friberg S, Mattson S. On the growth rates of human malignant
tumors: implications for medical decision making. J Surg
Oncol. 1997 Aug;65(4):284-97.
Balch CM, Soong SJ, Gershenwald JE, Thompson JF, Reintgen
DS, Cascinelli N, Urist M, et al. Prognostic factors
analysis of 17,600 melanoma patients: validation of the
American Joint Committee on Cancer melanoma staging system.
J Clin Oncol. 2001 Aug 15;19(16):3622-34.
Rouse CR, Allen A, Fosko S. Review of the 2002 AJCC
cutaneous melanoma staging system. Facial Plast Surg Clin
North Am. 2003 Feb;11(1):1-8.
Berwick M, Armstrong BK, Ben-Porat L, Fine J, Kricker A,
Eberle C, Barnhill R. Sun exposure and mortality from
melanoma. J Natl Cancer Inst. 2005 Feb 2;97(3):195-9.
Christophers AJ. Melanoma is not caused by sunlight. Mutat
Res. 1998 Nov 9;422(1):113-7.
Shuster S. Is sun exposure a major cause of melanoma? No.
BMJ. 2008 Jul 22;337:a764. doi: 10.1136/bmj.a764.
Millen AE, Tucker MA, Hartge P, Halpern A, Elder DE, Guerry
D 4th, Holly EA, Sagebiel RW, Potischman N. Diet and
melanoma in a case-control study. Cancer Epidemiol
Biomarkers Prev. 2004 Jun;13(6):1042-51.
Fortes C, Mastroeni S, Melchi F, Pilla MA, Antonelli G,
Camaioni D, Alotto M, Pasquini P. A protective effect of the
Mediterranean diet for cutaneous melanoma. Int J
Epidemiol. 2008 Jul 11. [Epub ahead of print]
Blanchard CM, Courneya KS, Stein K; American Cancer
Society's SCS-II. Cancer survivors' adherence to lifestyle
behavior recommendations and associations with
health-related quality of life: results from the American
Cancer Society's SCS-II. J Clin Oncol. 2008 May
Verma S, Petrella T, Hamm C, Bak K, Charette M; the members
of the Melanoma Disease Site Group of Cancer Care Ontario’s
Program in Evidence-based Care. Biochemotherapy for the
treatment of metastatic malignant melanoma: a clinical
practice guideline. Curr Oncol. 2008 Apr;15(2):85-89.
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