This super-sized problem threatens Trump's survival — and he's making it worse

If you were hung over on New Year’s Day, and decided to take it easy by reading the Wall Street Journal’s deep dive into Donald Trump’s aging and health, one item no doubt stood out, because it was so viscerally grotesque.

The Journal resurfaced an account of a McDonald’s meal Trump consumed on the 2024 campaign trail that would make anyone suffering from a New Year’s Eve booze-binge gag at the thought.

According to Republican National Committee chair Joe Gruters, Trump had fatty fresh fries followed by an off-the-charts cholesterol, carbohydrate and sodium binge: a Filet-O-Fish sandwich, a Quarter Pounder, and a Big Mac. It was a gourmand of guzzlement, not only vomit inducing but plain offensive to anyone who lives by the motto “you are what you eat.”

This obscene occasion of gluttony is a window into a long-standing pattern of Trump’s behavior, one that directly intersects with well-established medical science about aging, vascular health, and cognitive decline. Trump’s McDonald’s habit is central to his health and humanity.

In other words, when you are 20, it’s natural to feel immortal and adventurous with food. But a soon-to-be octogenarian surely understands the fragility of life and mortality. Unless, of course, the octogenarian in question is an obtuse, obstinate and obese oaf.

Trump’s long-documented dependence on McDonald’s is a dietary habit defined by ultra-processed foods, high saturated fat, excess sodium, refined carbohydrates, and minimal fiber, precisely the combination most consistently associated with cardiovascular disease, and in older adults, cognitive decline.

The medical consequences were demonstrated vividly two decades ago by the filmmaker Morgan Spurlock, with Super Size Me. In Spurlock’s experiment, consuming only McDonald’s for 30 days resulted in rapid metabolic deterioration, elevated liver enzymes, mood disturbances, and alarming cardiovascular markers. Physicians urged termination of the experiment due to the risk of lasting harm.

Far from distancing himself from fast food, Trump has elevated it. He staged a McDonald’s “work shift” as a campaign stunt, served fast food to NCAA athletes at the White House, and famously posed alongside allies surrounded by McDonalds boxes and bags on his private plane — making the health-conscious Robert F. Kennedy Jr. look a supplicant hypocrite.

These moments were presented as Trump being Trump, yet they are evidence of sustained exposure to a diet known to worsen the very conditions Trump either has or is at elevated risk of developing.

The Journal cited Trump’s claim of having “good genes.” He frequently cites the longevity of his parents as proof that he will similarly endure. What that narrative — like the WSJ article — omits is that while Trump’s father, Fred Trump, lived to 93, he suffered for years with Alzheimer’s disease.

That omission matters, especially when it applies to Fred’s fourth child.

Alzheimer’s disease and related dementias are complex, but decades of research point to strong associations with cardiovascular health, chronic inflammation, and, most pointedly, diet. It doesn't take a nutritionist or physiologist to figure out that a crummy diet makes a dummy brain.

Diets high in saturated fat and ultra-processed foods are associated with increased amyloid deposition, vascular dysfunction, and accelerated cognitive decline.

No credible clinician would claim McDonald’s “causes” Alzheimer’s. But no credible clinician would dismiss the cumulative effect of Trump’s dietary habits either, especially in an over-weight, exercise-phobic individual fast approaching 80.

Mary L. Trump, a clinical psychologist and Trump’s niece, has stated publicly that she recognizes in her Uncle Donald behaviors and patterns she observed in her grandfather as Alzheimer’s progressed. A plethora of examples suggest Trump’s mental health issues are progressing.

This was evidenced at 3am on Friday, when Trump alarmed the world by threatening Iran with war, saying the U.S. was “locked and loaded.”

Such middle-of-the-night Truth Social posts validate Trump’s brag that he doesn’t like to sleep.

And guess what? Poor sleep raises the risk and speeds the progression of Alzheimer’s by preventing the brain from clearing toxic proteins. Their build-up worsens memory and symptoms, creating a pattern in which disrupted sleep fuels the disease.

Sleep and diet are only two components of Trump’s disregard for medicine and doctor’s orders. The WSJ story lays out how he ignores medical recommendations on aspirin dosing, taking amounts far exceeding typical preventive guidelines, and not using compression socks to treat chronic venous insufficiency. Trump is making the condition worse.

All told, these are decisions that worsen vascular health, the system most closely tied to cognitive preservation. Yet Trump responds with defiance. He sees adhering to medical advice as weakness.

The irony is that Trump’s dismissiveness and insistence on projecting invincibility are defying and testing an unforgiving Mother Nature. When Morgan Spurlock attempted to do the same, doctors stopped his experiment. Trump has surrounded himself with aides and allies, even doctors, who enable it.

As Trump approaches 80, his spectacle of defiance gives way to something more sobering: the certainty that time always wins. Always. Fast food, bravado, and denial may fuel his persona, but they cannot outrun biology.

Trump has spent a lifetime supersizing, insisting the rules of physiology do not apply. But Mother Nature has the final say. She’s never wrong. And she never loses.

• John Casey was most recently Senior Editor, The Advocate, and is a freelance opinion and feature story writer. Previously, he was a Capitol Hill press secretary, and spent 25 years in media and public relations in NYC. He is the co-author of LOVE: The Heroic Stories of Marriage Equality (Rizzoli, 2025), named by Oprah in her "Best 25 of 2025.”