Muscle Is Best Target for Vaccination Shots

Now that all our waistbands are starting to tighten nicely (and we’ve only just embarked on the eat-like-crazy season), here’s something pleasant to contemplate: The fatter you are, the bigger the needle you need when you’re getting a vaccination.

That’s the conclusion of a British doctor named Jane Zuckerman, who works at the Academic Centre for Travel Medicine and Vaccines in London.

Writing in the British Medical Journal, Zuckerman notes that in days of yore docs used to vaccinate people in the tush. But that’s less common now because tushes are well-padded with fat--and most vaccines, it’s now known, don’t work so well unless the needle reaches muscle. The immune response isn’t properly triggered in fat. Plus it takes longer for the fluid of the shot to disperse, which means a greater chance of irritation and inflammation.

Muscle’s the thing, these days--and so docs tend to jab people in the leaner arm or thigh. But the standard five-eighths-inch needle won’t always reach muscle. That’s what Zuckerman and her colleagues conclude after measuring the thickness of fat above the upper arms of 220 adults, using an imaging method called high-frequency ultrasonography. Fully 17% of men and nearly 50% of women would have needed longer needles: 1-inchers, or even 1.5-inchers. Maybe wider gauges too. (Yikes!)

Zuckerman’s vision of the future is a clinic outfitted with a selection of needles of different lengths and gauges that docs can gleefully select from. For clinicians, this might have the added benefit of cutting down on all that patient carping about one-hour waits and skimpy paper gowns that manage to cover up absolutely nothing.

An Appetite for Sleep

Large-needle fright might provide some people with incentive to eat more modestly this festive season--at least when they’re awake. But what about when they’re sleeping?

We read an article recently on Healthscout.com (https://www.healthscout.com about people who suffer from a rare condition called nocturnal eating disorder. They bed down. Go to sleep. Then they get up, sleepwalk their way into the kitchen and fix themselves a calorie-laden snack, as many as several times during the night. In the cold light of morning, they survey the devastation--crumbs, empty Ding Dong wrappers, trails of peanut butter and jelly--and have no memory of any of it.

Not surprisingly, we further learn, many sleep eaters are overweight: The foods that our subconscious chooses for us are not the healthful low-fat slaws and salads but high-fat, calorie-laden treats. Sufferers also tend to have eating disorders as well as sleep disturbances, and they’re more likely to be female.

But people don’t have to be sleepwalkers to naturally chow down more at night. A lot of us do it, especially if we eat like birds during the day and let our blood sugar levels tumble. (Blood sugar tends to fall anyway in the evening.) And especially if you--like me--drink coffee, which curbs the appetite in the short term--but the short term only.

I’ll try to change my ways. In the New Year, perhaps.

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If you have an idea for a topic, write or e-mail Rosie Mestel at L.A. Times, 202 W. 1st St., Los Angeles, CA 90012, rosie.mestel@latimes.com.