Every now and then one pops up at work, down the pub, in the park, outside the school gate, or in your own family’s mythology. The person who claims never to get sick. Colds brush past them without leaving so much as a sniffle. They laugh in the flushed face of flu, spray hand sanitiser in the rheumy eyes of infection, and never take a day off work. They appear to be superhuman, with the kind of kickass immune systems the rest of us mere ailing mortals can only dream about as we dissolve another 1,000mg vitamin C tablet and hope for the best. What are their secrets? Can we become more like them? Do they even exist?
“I hardly ever get a cold, bug or infection,” says Lore Lucas, a 97-year-old Jewish refugee and Holocaust survivor who has lived in Glasgow since 1946. “I never drank or smoked, I sleep well and I like a little rest during the day, preferably in bed, or rather on the bed … just shoes off.” What about her diet? “I have been known to have a great dislike for cheese,” she replies, “and I really do not like the Scottish specialities mince, haggis, or porridge.”
During her professional life, first as a maternity nurse in Geneva, where she lived after fleeing Nazi Germany in March, 1938, and then as an office secretary, Lucas never had a day off due to sickness. Did she get ill after the war? “By that time, I was fully aware I would never see my parents, sister, grandparents, ever again,” she says. “Very traumatic … but matters turned much to my favour when I got married in 1946.” Lucas, who has one son and granddaughter and has been a widow for 30 years, puts her exceptional health down to a combination of good genes and a good life. Oh, and a good game of bridge. “To keep active, I play a lot,” she confesses over email as “my hearing aids do not work too well on the phone”. “I am quite addicted, I play in various clubs, and enjoy a social game at home.”
On average, each of us will get around 200 colds in a lifetime. Though some appear to suffer more than others, there is no evidence or, indeed, research on why, or if, that is really the case. “It’s pretty much hearsay and self-reporting,” says Dr Natalie Riddell, a lecturer in immunology at the University of Surrey and spokesperson for the British Society for Immunology. “I need more evidence before I can believe these people really exist.” Though there is no scientifically proven link between lifestyle and enhanced immune function, the immune-boosting industry and our unshakeable belief in it continues to flourish like flu during fresher’s week. Nutritional supplements alone, thought to be one of the world’s fastest-growing businesses, are predicted to be worth $60bn (£48bn) by 2021. As the American writer Eula Biss notes in her excellent book about vaccination, On Immunity, “building, boosting, and supplementing one’s personal immune system is a kind of cultural obsession of the moment”.
Meanwhile, for doctors and immunologists, the notion of superhuman health remains at best unproven and at worst a fiction. This is because of the highly individual and complex nature of our immune systems, which are almost as specific to each of us as our fingerprints. “Some of us inherit a set of immune system genes that are particularly good at dealing with one particular virus,” explains Daniel Davis, professor of immunology at the University of Manchester and author of The Compatibility Gene, which explores how immune system genes shape our biology. “But that is not to say that you or I would have a better or worse immune system. All it means is that you would deal with a particular flu virus better than me. There is an inherent diversity in how our immune systems respond to different diseases and that diversity is essential to how our species survives disease.”
Much of this diversity comes down to our inherited genetic makeup. “The greatest diversity in all of the 25,000 genes that make up the human genome is in our few immune system genes,” Davis explains. “That means that the genes that vary most between us all are the ones that influence the immune system.”
This unparalleled diversity makes generalisations about stronger or weaker immune systems meaningless. It also throws into question the benefits of all the products out there claiming to boost our immunity; antioxidants, vitamin C, hot lemon and ginger tea, garlic, echinacea, or wheatgrass. Do any of them work?
“The bottom line is that we simply don’t know,” Davis says. Or, as GP and Guardian contributor Ann Robinson puts it: “Keep your scepticism wrapped around you like a cloak.”
So why do some people simply seem to be better at fighting infection than others? “Maybe people at the top end have been primed through early exposure to bugs, fully vaccinated, and so on,” Robinson says. “Each person is wired to be slightly better at fighting off some illnesses and slightly worse at fighting off others,” is how Davis explains it. Both also point to growing evidence that our gut microbiome - the range and quantity of microbes in our guts - impacts the immune system. So there is a link between diet and immunity? “It’s a hot topic,” Davis says, carefully. “Although gut microbiome directly affects the immune system, precisely how isn’t yet clear.”
For 55-year-old architect Jenny Hunter, who “very, very rarely gets ill”, lifestyle and attitude play a part. “My mum didn’t tolerate illness,” she recalls of her childhood, the first five years of which were spent in Australia. “If I thought I was ill she would send me to school and say I’d feel better. She was right … brutal, but right.” What does she do to maintain her health? “My grandfather used to have a cold bath every morning but I don’t have any secrets or perversions,” she laughs. “I have a good diet, keep busy, and I do yoga, pilates and running every week. And I do think happiness plays a part. My default setting is that life is good.”
For Riddell, lifestyle plays a significant part in the functioning of our immune response. “The immune system is not solely governed by genetics,” she insists. “One of my research interests looks at how stress can negatively impact immune function. We have seen a dampening of immune responses among, say care-givers, versus the non-care-giving community.”
Thomas Walters is a writer and retired academic who refuses to tell me his age but concedes that he is “probably in his final decade”. He has never seen himself as a person who gets ill – in fact, the only illness he can recall having as an adult is shingles, “which passed amazingly quickly”. His lifestyle, like those of all the people I speak to who claim to never get sick, is balanced, moderate, social, and suffused with a positive outlook. “I drink a reasonable amount – one glass of wine a day and sometimes whisky,” he tells me. “I’ve always walked as often as possible. I did smoke for a brief period … Gauloises, because I liked France and the blue packets, but I gave up easily. I sleep extremely well, enjoy my dreams, and have very few nightmares. I tend to work until 10pm and have just finished a book about a late-Victorian architect. I would say my brain is as good as it’s ever been.”
Does he think his good health might be inherited? “I’m three-quarters Welsh peasant and one-quarter French peasant,” he notes. “Tough people. Plenty of my relatives checked out in their 90s, although my parents didn’t live to a great age. My father had a very stressful career and my mother had cancer and died in her mid-60s. I’ve never had that kind of career stress.” Later, Walters emails me with a warning: “Remember, even the healthiest of whales has barnacles growing on it, and bears the scars from scraping against undersea rocks. I recall a Hindu sage who once said: ‘The body itself is a disease.’”
Part of our fascination with the idea of superhuman resistance to illness is the way we view health itself. Not as “a transient state that we may be exiled from without warning”, writes Biss in On Immunity, but as an identity. “Health, it is implied, is the reward for living the way we live, and lifestyle is its own variety of immunity.” For doctors and immunologists, this not only demonstrates a false understanding of the way the immune system operates - the innate and acquired systems working in tandem to neutralise infection so that a cold is, in fact, evidence of an immune system working robustly – it is an unhelpful, even dangerous way to view illness.
“It’s why doctors worry about positive-psychology arguments,” says Robinson. “It implies that if you ‘succumb’ to illness, you’ve somehow lost. Beware the lure of positive psychology if it suggests you’re weak if you get ill.” Perhaps we should view viruses not as the enemy but as the educators of our immune systems. “We might view colds as little boosts and challenges to our immune systems,” Robinson says. “Maybe when we get over a virus we should remember not to moan about the cold but to give thanks to our immune system for fighting it.” Does she believe in the phenomenon of people who never get ill? “I can see neither the evidence nor the benefit of so-called superhumans,” is her reply.
“It’s pretty hard to know whether there is such a phenomena,” Davis agrees. “For me, there is an exceptionally important message in this. All the great tragedies, from slavery to the Holocaust, have come down to a misunderstanding of the differences between people. Not only is our greatest human difference nothing to do with how we look, it is down to our immune systems, and there is no hierarchy in them.” For Davis, narrowing the diversity of our immune systems, even if it were possible, would be undesirable. “That kind of misinformation can lead to people saying we can create humans that are better than others. I strongly believe that is not the case.”
As far as Walters is concerned, “we can do nothing about any of it other than take care of ourselves”. So does he have any tips on how to become, if not superhumans, then our most healthy selves? “Maintain a constant high pitch of curiosity,” he replies after some thought.
• Some names in this piece have been changed
How to never get ill
• Be realistic. There is no such thing.
• Don’t smoke and don’t drink too much alcohol.
• Wash your hands regularly but remember that infections are mostly passed on through proximity. “If you want to avoid a person’s cold on the tube you are better off moving carriage than using hand sanitiser,” says GP Ann Robinson.
• Exercise regularly, moderately and remember to rest. There is evidence that regular exercise, which improves circulation, can boost immunity, though to what extent is unknown.
• Manage stress. “The best established link in terms of how lifestyle impacts the immune system is that stress levels relate to your immune system’s behaviour.” says Professor Daniel Davis. Chronic longterm stress produces cortisol, which neutralises immune cells.
• Immunise, immunise, immunise: if you’re likely to be at increased risk of infection, whether through chemotherapy, long-term steroid use, or pregnancy, get yourself vaccinated.
• Maintain a healthy and varied diet, but don’t go overboard. This connects to the latest research around the importance of our gut microbiome. “A lot of the chemicals important to our immune system originate in the gut,” says Robinson.
• Sleep well. “Sleep has a massive impact on the immune system,” says Dr Riddell. “It’s under the control of circadian rhythms and disturbing it can throw out your immune system.”
• Stay connected. “If there is one thing that’s the enemy of wellbeing it’s loneliness,” says Robinson. “Get out there and connect with people … if not with their viruses.”
