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President Barack Obama “is in excellent health” and likely to remain able to carry out his duties for the rest of his term, his doctor said on Sunday after completing Obama’s first routine medical checkup since he assumed office.

But 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 Obama’s physical.

The examination also found that 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.

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, Kuhlman’s report said.

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 the increase was attributed to the president’s diet. While 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, 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, 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 Obama’s cholesterol has fluctuated over recent years and represents such a variation.

Doctors see a rise in cholesterol like Obama’s occasionally, said Dr. Martin L. Kahn, a professor of cardiology at New York University who is not connected with 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’,”’ 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,” Kahn said.

As for Obama’s smoking, Gibbs said the president had tried to quit, but had “admitted lapses.” It is not known how frequently 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.

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 per cent of smokers began on or before their 18th birthday.

“I know - I was one of those teenagers,” 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 per cent cured, but there are times where I mess up.” Michelle Obama admonished him to quit smoking when he started his campaign in 2007, saying, “He couldn’t be a smoking president.” Obama chews nicotine gum to cut down on his smoking.

“Have I fallen off the wagon sometimes? Yes,” Obama said last June at a White House news conference. “Am I a daily smoker, a constant smoker? No.” Kahn said he might recommend an exercise stress test “as a baseline” for the future but would not do further procedures “unless he had a calamitous stress test.” Obama showed no evidence of heart disease from an electrocardiogram and a test known as an electron beam CT scan that looks for calcified areas in coronary arteries that may be evidence of coronary artery disease.

“The CT heart scan findings are somewhat reassuring” because if it were positive, “it would be a worry,” Kahn said.

Other standard blood tests showed no evidence of diabetes, heart and metabolic disease. They included triglycerides, 46; high density lipoprotein, 62; and low density lipoprotein (so-called bad cholesterol), 138. These can be compared to 44, 68 and 96 in 2007.

The president’s pulse rate of 56 and blood pressure of 105/62 are normal.

Kuhlman, who is physician to the president, chief White House physician and director of the White House medical unit, said that Obama agreed to release the results of his checkup, which took place at the National Naval Medical Center in Bethesda, Md.

While there, Obama visited 12 military service members receiving treatment and rehabilitation for injuries suffered in Iraq and Afghanistan. The White House declined a request to interview Kuhlman.

Another CT scan known as a virtual colonoscopy or CT-colongraphy showed no evidence of colon cancer. Gibbs said that no sedation was required during the test, so it was not necessary to invoke the 25th Amendment, which would have temporarily transferred power to Vice President Joe Biden. A previously undisclosed medical examination of Obama in July 2008 by a congressional doctor was not conducted for any specific issues, Gibbs said. It came one month before Obama formally accepted the Democratic presidential nomination.

A standard group of tests, including those for thyroid function, were normal. A PSA test for prostate cancer was normal: 0.70 compared with 0.6 in 2007.

Kuhlman recommended that Obama get his next routine checkup when he turns 50 in 2011.

One oddity of the report: Obama weighed 179.9 pounds with his shoes and workout attire on, which is not the usual way to measure a patient’s weight.