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Smoking lounge Sugar East opens on Upper East Side

Hold on to your butts.

Smoking may be banned in most businesses and public spaces, but the city is home to several holdouts where it’s still legal to light up a cigarette or cigar indoors.

The newest of the bunch opened last week on the Upper East Side.

Sugar East is one of only eight bars where you can still smoke legally indoors. An outdoor cigar lounge is also located on the rooftop of the two-year-old Knickerbocker Hotel in Times Square, currently operated by Upper East Side cigar bar Club Macanudo.
Sugar East took over the space previously occupied by the 20-year-old Merchants NY Cigar Bar, which closed late last year.
Merchants Hospitality, which operated the original cigar bar, revamped the space with a Havana nightlife-inspired theme and modern cocktail menu.

“We decided to transform Merchants Cigar Bar into a casual smoking lounge, so you can just have a cigarette during a night out while enjoying a cocktail and some great music,” said Abraham Merchant, president and CEO of Merchants Hospitality.

The city’s Smoke Free Air Act, which went into effect in 2003, bans smoking inside restaurants and bars, among other businesses and certain public spaces. But it offers an exemption to establishments that were already in existence, have not moved or expanded, and earn 10 percent or more of their income from tobacco sales. Since the ownership and size of the Sugar East space has not changed, the exemption remains.
Merchant sees Sugar East as appealing to a younger demographic than your typical, exclusive cigar bar.

“Cigar bars in New York are not designed for the millennials, they’re designed for people enjoying cigars, and most millennials don’t know where to have a smoke at the end of the night,” Merchant said. “We decided to give something to people that no one has — a place where you can go and have a good time in a safe environment, so you don’t have to go hide in the back of a club to smoke illegally.”

For social smokers like Danielle Cohen, “having a place to go where you can not only drink but also decide to smoke if you want is an added bonus,” the Midtown East resident, 32, said.

At the same time, the clientele for a smoking lounge is decreasing. Overall, tobacco use — the leading cause of preventable death in the U.S. — has been on the decline nationally. According to the Centers for Disease Control and Prevention, 15.1 percent of all U.S. adults were current smokers in 2015, versus 20.9% in 2005.

Measures such as smoking bans and cigarette tax hikes have helped contribute to that decline, said Dr. Jonathan H. Whiteson, vice chair at NYU Langone’s Rusk Rehabilitation.

“Banning cigarettes in bars was a large step to marginalizing the culture of tobacco use,” said Whiteson, who believes more can be done to further bring the number of smokers down. “If we start to see a rise in smoking lounges, that’s not the culture that we want to be promoting for a habit that is so addictive, so directed at the youth and so lethal in its outcomes.”

With Meredith Deliso
These are the remaining establishments where it’s legal to light up indoors in NYC:
Sugar East (formerly Merchants NY), 1125 First Ave.
Grand Havana Room (members only), 666 Fifth Ave.
Hudson Bar and Books, 636 Hudson St.
Lexington Bar and Books, 1020 Lexington Ave.
Club Macanudo, 26 E. 63rd St.
Karma Lounge, 51 First Ave.
Soho Cigar Bar, 32 Watts St.
The Carnegie Club, 156 W. 56th St.

More Than Half Of “Normal Weight” Americans Actually Have Too Much Body Fat

More Than Half Of “Normal Weight” Americans Actually Have Too Much Body Fat

(CBS) April 2, 2008

Think you can tell whether people are overweight just by looking at them?

Guess again.

New research from the Mayo Clinic finds that more than half of Americans considered to be at a normal weight actually have a high percentage of body fat — more than 20 percent for men and 30 percent for women.

Doctors call it “normal weight obesity.”

Too much inside the body fat is linked to heart disease and diabetes.

On The Early Show Wednesday, Dr. Jonathan Whiteson of New York University Medical Center pointed to a colleague, Lori Butler.

“To look at her, she looks great,” he said. “When you weigh her and you check her height as well through the body mass index, she comes out also at a normal range, but when you actually look beneath the skin and you look at the fat weight, then we realize that she actually has a higher percentage of body fat.

“There are different methods to test body fat. We used a technique called bio-impedance analysis. It’s a fancy term. It’s a very simple test. We have a little box with electrical equipment and some wires that are attached to a hand and a foot, and by turning on the machine, we’re able to record the resistance of the electricity through the body, and based on that, we can tell the percentage of body water, of lean body mass muscle, and also of body fat.”

Butler’s was 35 percent — too high.

She says that surprised her, and she plans to “definitely eat healthier, change my diet.”

“With Lori,” Whiteson sais, “this is really the only the risk factor that she has. She has a high body fat percentage. So, we need to change diet. We need and try to reduce her weight and lose some of those fat pounds. We must also make sure her blood pressure is good and diabetes is not present.”

Whiteson says doctors should “think about fat testing as part of typical screening. If you don’t, you are going to be fooled into thinking everything is OK, when it’s not.”

COPD – the overlooked smokers disease!

About 20% of adolescents and adults smoke. Most people start smoking in their teens and many continue the habit for a lifetime. But a short lifetime! Smoking on average reduces life expectancy by 14 years. While most of us can expect to live these days into our 80’s, smokers are more likely to die in their sixties and seventies! Close to half a million people die from smoking EVERY YEAR! And overall cost of care and lost ‘productivity’ – what industry and the overall economy loses because sick smokers cannot work, is close to $92 BILLION EVERY YEAR.

No matter how many times I look at these figures, they still amaze me. Any way you look at this, it is a national and a personal disaster. And a preventable one at that! That makes the disaster a full blown tragedy as well. It breaks my heart when I have to counsel families and patients that they are dying from smoking related disease. And the guilt and anger as all realize that this disease was caused by smoking – an avoidable habit!

I run a smoking cessation program. Hundreds of people come to see me who are smoking and want to quit. Many have tried 4, 5 or 6 times before. Some are young and realize the future consequences of continuing smoking. Sadly many are older, in their 50’s, 60’s and 70’s and they have been told they have a smoking related disease and MUST stop smoking to have any chance of living a productive life. Nearly all don’t realize when they see me that their life expectancy is already significantly reduced. However it is NEVER TOO LATE TO QUIT!!! At any stage of any smoking related disease, it is always better to quit than to continue. Every single cigarette damages further. And the moment a smoker quits, the moment the body can start to make a recovery.

Many patients I see are surprised at what diseases smoking causes. As far as I know, there is no part of the body that is not affected by smoking. Every single organ system is affected: lungs, heart, brain, kidneys, breast, gastrointestinal system, skin, muscle, bone to name but a few. Heart attacks, cancer of just about every organ, strokes, vascular disease of the legs and all major vessels. And to many, a little known entity or disease process called COPD – chronic obstructive lung disease. Many patients come to see me who are weak, get very short of breath when they exert themselves and find it hard to wash, dress, prepare a meal, walk outside because they get so fatigued, short of breath and exhausted. They have smoked, either in the past or currently and have been told by their Doctors they have COPD. Most of them have no idea what this is. They are prescribed medications – puffers and inhalers, similar to those used by people with asthma, and the lucky patients have Doctors who realize that Pulmonary Rehabilitation – a program designed to overcome the medical, physical and emotional problems associated with COPD – can be very helpful in restoring people to a functional, enjoyable and productive life.

I will talk more about Pulmonary Rehabilitation in a future blog. For now, I want to talk about COPD. Chronic Obstructive Lung Disease is one of the most common smoking related diseases – in fact, more than 85% of cases of COPD are caused by smoking. The remaining 15% is caused by pollutants and environmental fumes, as well as genetic disorders. Over 16 million Americans have been diagnosed with COPD and it is estimated that at least 25 million have it – that means there are millions who have COPD, suffer its consequences but yet have no idea they have it. Likelihood is these people continue to smoke, and so continue to damage their lungs.

When I am lecturing and teaching about COPD, I ask the Doctors and students what is the most common symptom – complaint – that patients with COPD present with: “shortness of breath”; “exhaustion”; “cough”; “sadness and depression”; “weakness in their muscles” are some of the answers I hear. And while these ARE some of the complaints that patients have, most commonly patients with COPD have NO complaints or symptoms!! None what-so-ever! This is best explained and understood using the concept of ‘reserve capacity’. Every organ system, when it reaches full size has way more capacity – function – than it needs at that moment in time. At any one time we use only a fraction of our brain tissue – so much of the brain is held back in reserve to be called into function only if other parts of the brain are injured. Living kidney donors can donate a kidney with out any loss of overall kidney function and a normal life expectancy. And our lungs have so much functioning tissue that it is not until over 50-60% of that tissue is lost or destroyed by smoking that symptoms such as shortness of breath, weakness and fatigue will develop. Sadly, by the time symptoms develop and so much lung tissue is damaged, further loss of lung tissue from whatever reason makes a significant impact on remaining lung function and accelerates the progression of symptoms.

So the most important message I can get across to the attendees at my lectures, and to the patients and families I see in my office is to recognize that any and all smokers most likely have COPD, and the absence of symptoms does not give reassurance that there is no COPD present. Stopping smoking is the single most important treatment for COPD. And helping smokers quit as early as possible is vital to limit the chances of developing COPD later in life.

COPD is an umbrella term for a group of conditions caused by smoking: chronic bronchitis and emphysema. Chronic bronchitis is a condition of airway inflammation with copious amounts of sputum being coughed up for many months a year, and many years in succession. At times the mucus is so voluminous and thick it blocks the airways in the lungs and oxygen can not get through these breathing tubes and into the body. Emphysema is a condition where the cigarette smoke destroys the lung tissue so instead of an abundance of lung tissue volume, more and more is destroyed and less is available for oxygen to cross from the lung airways into the blood vessels for distribution to the other body organ systems. The common pathway for these disease processes is lack of oxygen. Oxygen is essential for muscles, brain and all organ systems to make energy molecules that power all body functions: no oxygen – no energy molecules – no power – FATIGUE, SHORTNESS OF BREATH, NO ENERGY TO DO NORMAL DAILY FUNCTIONS, SOCIAL ISOLATION, DEPRESSION.

Treatment for COPD is multi-factorial: stopping smoking is most important and most effective in the long term. Smoking cessation programs, like the one I run at NYU Langone Medical Center are vital for successful quitting. Medications are essential – inhalers and puffers help open inflamed and tight lung airways. Antibiotics treat infections that often exacerbate COPD. Corticosteroids by pill and by inhalers decrease inflammation in the airways. Expectorants thin-out thick sputum and mucus making it easier to clear – cough out. Oxygen supplementation increases low oxygen levels and can be life saving when used for many years – oxygen always increases energy and reduces fatigue. Emotional support is very helpful and critical to improve quality of life. Relaxation therapies including visualization and meditation coupled with breathing re-training, help overcome the very distressing symptom of shortness of breath and the associated anxiety. Nutritional counseling is very helpful as patients with COPD can suffer either from overweight and obesity due to poor tolerance of physical activity, or from malnutrition due to poor meal tolerance and abdominal bloating from the accidental swallowing of air during breathing.

As well as smoking cessation in terms of its benefit in the management of COPD, Pulmonary Rehabilitation is essential to help people limited by their disease and symptoms restore themselves to wellbeing and function. I run a very active Pulmonary Rehabilitation program and it has been my pleasure and an honor to help so many people debilitated and limited in the community from COPD to recover strength and energy and teach them how to live more healthy and productive lives.

It remains my opinion that COPD – both chronic bronchitis and emphysema are vastly under-recognized and much more prevalent than currently believed. While we think of lung cancer, heart disease and stroke as being THE smoking diseases, it is COPD – the overlooked smokers disease, that I feel causes the most amount of smoking related disease and disability.

So live well and long by stopping smoking, start exercising and if you have COPD and want to protect your future, come see me!!

Kids in the kitchen – help or hindrance?

Kids in the kitchen – help or hindrance?

So a little about me….

I am originally from England – you would have known that if you read the “about Dr Whiteson” in the bio!! I met my future wife in London back in 1985. She was 17 and I was 20, a poor medical student who took a job as a tour leader and met his bride-to-be. Long story short, Janine, an American, moved to London, completed her studies, went on to follow her career passion – Nutrition – completing a Masters of Science in Nutrition at the world famous Kings College, London. She launched her career as a Nutritionist, counseling her many clients on good nutrition for health, and how to avoid common ailments like diabetes, obesity and heart disease. Fast forward 15 years and here we are, in New York City with 2 young boys facing the challenges we all face as individuals and parents in a society pulled towards fast food, leisure time spent in front of computer screens and TV and a trend of declining health amongst young and old alike.

Both Janine and I in our respective lines of work are seeing dietary related disease in younger and younger people and children that we used to see only in older people. And the National statistics support this as well.

Childhood obesity has nearly tripled in the past 30 years, now approaching 20% – that is 1 in 5 kids are OBESE !! Nearly 1 in 3 are overweight!  Match that to the rising trend of kids eating fast foods!

More and more kids spend leisure time in front of TVs and computer games and so are doing less activity and sports.  This has a direct correlation with increasing obesity, diabetes and high blood pressure rates seen in children.

And adult onset, or type 2 diabetes – the diabetes associated with being overweight and not normally seen until people reach their 60’s and 70’s – is now developing in children at an alarming rate.

The outcome of  all of this is the rising incidence of risk factors for heart disease in our children that can lead to premature heart disease when these children reach their 40’s and 50’s! Now that is just too young to have heart disease!!! And don’t forget that for many, the presentation of heart disease is sudden death from a heart attack!  Also consider that heart disease for the most part is preventable, and start thinking that somehow, someway we are doing ourselves, our kids and society in general a huge disservice by allowing this to happen.

Every day, I work with victims of heart disease. Men and women as young as mid-30’s, right through to those in their 80’s and 90’s who, due to poor attention to childhood and young adult lifestyle habits, developed high blood pressure, high cholesterol, diabetes, obesity, smoked or were overly sedentary. I see them scared, suffering and wondering what the future holds. It is a challenge to make changes at that stage in life, to turn things around and do the right thing for your heart health. As I said, this is the work I do every day, and for the most part, have really excellent success! (there are sadly always some situations impossible to reverse, or even more sad, some people who just cant, or wont, reverse their deadly habits!) But how I long for the day when the focus of my practice turns from putting out the raging fires of established heart disease, to spending more and more time with younger adults and children helping them live heart healthy lifestyles, prevent those risk factors I have been talking about, and so see them live long, healthy, productive lives free from heart disease.

Janine and I, as parents of two young boys, think of their future in a society that is in the midst of a heart disease epidemic. There is no doubt they are as vulnerable to the pressures of our society as any kid. They see the commercials for fast food, for sedentary computer games and TV shows. They like candies and ice cream and burgers like any kid. They love to ‘game’ on their computer consoles with other kids half way around the world. At school, they cry for the chicken nuggets, pizza and toasted cheese sandwiches. And the school vending machines are crammed with high calorie high sugar colas. It looks like the odds are stacked against us!!! And while the Government is trying, on all of our behalf, to control this fragile situation of the health of the nations children, the final responsibility and actions fall to you . us – the parents / aunts / uncles / grandparents of our kids.

So what can you do? Well, I can tell you what we do and see if you can get some ideas for your kids. Another time I will go into details of activity and exercise for your kids, but for now suffice it to say that I think your kid should be getting at least 1-2 hours of moderate to vigorous activity daily. Now that may be more than the current Government recommendations, but it is a target set to overcome the the 2-4 hours that most kids spend every day sedentary in foront of the TV or computer!

So what about our kids nutrition? Well we believe in bringing our kids food ‘back into our home’. Getting back to home cooking! Don’t forget, the more you eat out, at diners, fast food joints, even school cafeterias, the less control you have over what your kids eat. You are losing an opportunity to provide heart healthy foods to your kids and to teach them about food basics that can lead to healthy food habits for a lifetime. Of course we realize that fast food and school lunches allow us more time for our own busy lives, but we are not doing our kids any favors.

Instead, we focus a lot of our time on food. Not in an overly compulsive or obsessive way, but we make it fun and a family project. We start by planning as a family for some meals for the week that we all love. A pasta dish, a stir fry, fish, burgers. You can chose anything you like. Work out what ingredients you need – make a list. Do this with your kids. It can be so much fun and depending on their age, there can be so many talking points and chances for ‘education’. As a family, once or twice a month (I know my wife goes more often to keep us stocked up in-between, and we don’t want to ‘make’ the kids go more often so it becomes a ‘chore’) we go to the supermarket and shop. I LOVE supermarket shopping! We have such a laugh! But also to wonder at the amazing variety and colors, shapes, feels and smells of the fresh produce. Where in the world do they come from. We talk geography and travel. Fantasize about trips to discover new fruits and foods. For my 5 year old, we count out the pieces of fruit, we practice reading cereal boxes – he can only have a chance of getting the cereal he wants if he can read the name of the box! My 11 year old is starting to read food labels. If he cant pronounce the additives – he cant have the product – that counts out most of the over-processed pre-oackaged foods that not even we can read the additives and in any way, we feel, are just not good for you. We talk about fat, about sodium, about organic farming vs. hormone derived meats and milk. He understands and is very interested. It is a ‘green’ conversation, and America’s kids are understanding more and more about the environment, chemicals and toxins. While we are shopping we also talk about our meals and dishes we are going to cook – out stomachs rumble with anticipation.

Once home, as a family we put away the foods – fridge, pantry etc. And then we start to cook. All together, as a family! We all have our roles. Ellis (5 years old) will pour, mix, taste test. Harris (11 years old) will chop, stir fry, serve. Janine (ageless!) will supervise, add herbs and spices to flavor, direct cooking times and heat. I do everything else! Peel, throw out garbage, wash up! Again, cooking has become a family affair. Fun, a time to practice different skills, for my wife and I to feed back how well the boys are doing – positive feedback about their cooking skills has really helped us keep this ‘nutrition plan’ going.

When we eat, we sit down as a family. We pay attention to serving sizes – avoiding super-sizing our kids meals. We eat slowly and taste the food by chewing slowly. We try to make it a relaxed time. Together we enjoy the ‘fruits of our labor’! And enjoy we do. Even if we missed the mark and something does not taste as we thought it would, or is too dry, too cold, not tasty enough, we still have really enjoyed the whole process. And cant wait to do it again later in the week. Janine and Harris will cook together 2 or 3 times a week. Quick and easy meals. Simple. But the benefits are significant and long lasting. Family time, a chance to discuss, learning about health and nutrition, giving our kids the knowledge and practical tools to move forwards with a heart healthy lifestyle.

A few other points: every now and then we do let the kids have fast-foods. As a treat. They enjoy it and it satisfies their inquisitiveness or they get the toy from the latest movie they saw. For the most part, we make the kids sandwiches for school lunch, and provide a snack and a piece of fruit. Even a PBJ sandwich is better than most school cafeteria foods. We give them water and steer them away from the sodas. We don’t have soda at home. Drinking choices are #1 water, #2 skim milk, #3 OJ – not too much – high in calories, #4 AJ. What else do you need?!?!?! Snacks at home start with fruit, vegetables or a fat-free yoghurt. If they are still hungry (usually not) then small portions of goldfish or cheese-flavored cracker snacks satisfy.

So remember that it is YOU who is in control of your child’s health. The responsibility is yours – not the schools or the teachers or the Government, and certainly the fast food chains care very little for your or your kids health, no matter what they say or advertise! Take the responsibility, shop and cook and eat with your kids, and have fun family time while doing it. As you get into the swing of this you will clearly see, kids in the kitchen are a great help, never a hindrance.

Eat well – have fun – live well!

Electronic Cigarettes: Are They Safe?

Electronic Cigarettes: Are They Safe?

Electronic Cigarettes: Are They Safe?
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The medical information provided is of a general nature and cannot substitute for the advice of a medical professional. Consult with your physician.