Timothy had always been health-conscious. After years of social drinking, she decided to quit alcohol for good. But giving up the ritual of sipping on a drink at social gatherings felt impossible. That's when alcohol-free beer and wine seemed like the perfect alternative—offering the taste and experience without the intoxication. However, what Sarah didn't realize was that these supposedly "harmless" drinks might still be affecting her liver in ways she hadn't anticipated.

With a global shift toward healthier choices, the rise of alcohol-free beverages has been fuelled. Do these drinks, however, live up to their promise of being risk-free? New research shows that while they may eliminate the dangers of intoxication, they still pose metabolic and liver-related risks, which calls for moderation in the long run.

What Happens in your Body within 10 Minutes of Drinking Alcohol-Free Beverages?

The first time you take a sip of an alcohol-free beverage, your body responds almost instantly. Anshul Singh, Lead Clinical Nutritionist and Dietetics Department says, "In as little as 10 minutes, your taste buds have picked up on the flavors, and your brain might even get a placebo effect, giving you the sensation that you're about to be drunk. Some alcohol-free drinks have up to 0.5% ABV, which goes into the bloodstream in minute quantities but will probably not affect you in any significant way."

By the 30-minute mark, your body has metabolized the sugars, artificial sweeteners, or additives in the drink. "Some people may experience a mild insulin spike, which can cause temporary energy boosts. Some non-alcoholic drinks also contain fermentation byproducts or botanical extracts that mimic the sedative effects of alcohol, causing slight drowsiness or relaxation," adds Anshul.

After 60 minutes, most of the drink has been metabolized. Although there is no risk of intoxication, repeated consumption can subtly affect metabolism, gut health, and even trigger cravings for alcohol among those in recovery. Those sensitive to sugar, caffeine, or preservatives might experience even more pronounced effects over time.

How Alcohol-Free Drinks Affect Your Gut and Liver Connection

Your liver and gut health are connected, forming what is called the gut-liver axis. Anshul emphasises, "Even though drinks without alcohol seem harmless, they usually contain sugars, artificial sweeteners, and fermentation byproducts that can disturb this delicate balance."

• High sugar content may lead to insulin resistance, inflammation, and fat accumulation in the liver.
• Artificial sweeteners may change the gut microbiota, causing metabolic imbalances.
• Preservatives and artificial flavors can also enhance gut permeability, thus potentially leading to leaky gut syndrome.

Long-term consumption of these drinks may gradually affect digestion, liver detoxification, and overall metabolic health, making moderation necessary.

Do Alcohol-Free Drinks Still Trigger Liver Enzymes?

Even though these nonalcoholic beverages contain virtually insignificant alcohol, the liver processes them as well. "These small concentrations of alcohol-which may go as high as 0.5% ABV-trigger the liver's detoxification pathways but only at much weaker intensities compared to ordinary alcoholic drinks. But the added sugars, artificial sweeteners, and preservatives in the products could pose significant pressure on liver functions over the long term," explains Anshul.

High sugar intake causes insulin resistance, which can lead to the buildup of fat in the liver and increase the risk of developing NAFLD. Some fermentation byproducts in these beverages also trigger oxidative stress, which puts extra pressure on the liver. Though occasional consumption will not pose a significant threat, regular consumption might lead to chronic liver stress and metabolic imbalance.

Do Non-Alcoholic Beverages Affect Liver Detoxification?

Although trace amounts of alcohol exist in alcohol-free beer and wine, the body will still have to metabolize them. The body employs the same enzymatic pathways used for alcoholic beverages but at a much lower intensity. However, the added sugars, preservatives, and fermentation byproducts present their own set of challenges:

• Mild inflammation to the liver due to the additives and byproducts within the drinks.
• Insulin resistance resulting from excessive sugar intake, causing fat accumulation in the liver.
• Detoxification pathways are overburdened, and impairment of liver function occurs gradually.

Alcohol-free drinks do not cause the liver to become overwhelmed as traditional alcohol does, although it does have a lower, but still important, risk for someone who is drinking too much. For someone with a problem of liver disease or metabolic syndrome, limiting alcohol-free drinks is also important.

Should You Drink Alcohol-Free Beverages?

Alcoholic beverages have always been a dangerous drink, but the safer option for those who want to avoid intoxication. However, it is not totally risk-free. Its impact on metabolism, gut health, and liver function cannot be ignored. Although they are not harmful at first, their consumption over a long period leads to insulin resistance, liver stress, and imbalance in the gut.

For the consumers who love these drinks, moderation is the way forward. The expert shares, "The choice of brands with the least additives, lower sugar, and natural ingredients will reduce risks. In addition, supplementing with a diet that is rich in antioxidants, fiber, and hydration can complement the liver in general."

For most, thought that adopting alcohol-free beverages was a healthier decision. On discovering their side effects on liver health, though, she learned to limit its intake and settle for alternatives that included infused sparkling water, herbal teas, or even kombucha with controlled sugar levels.

The bottom line? Alcohol-free doesn't mean consequence-free. The best way to achieve long-term health is by paying attention to what goes into the body and yet still enjoy social rituals of preference.

Anshul Singh is the Team Lead with the Clinical Nutrition and Dietetics Department at Artemis Hospitals in India.

One of the most common contributing factors in lung cancer is smoking but a recent report suggests an alarming pattern in which cases among non-smokers are on the rise.

Pope Leo XIV was recently diagnosed with lung adenocarcinoma, a type of aggressive cancer that develops in the cells lining the lungs. He had no history of smoking. The 71-year-old pontiff underwent surgery to have part of his right lung lobe removed. According to reports, he is out of the hospital and recovering well.

Another case is of Stanford physician Bryant Lin whose stubborn cough led him to seek medical attention. After six weeks, he underwent an X-ray. The diagnosis stated that he had stage 4 lung cancer. Lin was less than a month away from turning 50, and he had never smoked a cigarette in his entire life.

“Definitely a shock,” Lin recalled according to The Washington Post. By the time doctors identified the cancer in spring 2024, it had spread to his liver, bones and brain.

According to the US Centers for Disease Control and Prevention (CDC), around 10% to 20% of lung cancers in the United States are reported in people who have never smoked or have smoked fewer than 100 cigarettes in their lifetime. That amounts to an estimated 20,000 to 40,000 cases annually.

For these patients, their no-smoking history can delay diagnosis and treatment. Hence, researchers are now looking into how environmental exposures, genetic causes and the biology of tumours may contribute to lung cancer in non-smokers.

Lung Cancer In People Who Have Never Smoked

Also read: Pope Leo XIV, Diagnosed With Lung Cancer, Undergoes Surgery As His Brother Battles Relapsed Multiple Myeloma

Smoking remains the leading risk factor for lung cancer. But other reasons like exposure to radon, secondhand smoke, air pollution and asbestos can also increase risk. Family history plays a role, especially when a first-degree relative has cancer before age 50.

Researchers are also examining genetic differences that may help explain why some people develop lung cancer despite never smoking.

A study published in September identified a rare genetic mutation concentrated in the southeastern United States that was associated with a 60-fold higher risk of lung cancer among non-smokers. The finding focuses on a possible role for inherited susceptibility, but it does not explain most cases in this group.

Lung cancer also has a different demographic profile among people who have never smoked. Women who have never smoked are more than twice as likely as their male counterparts to develop lung cancer.

“Two-thirds of nonsmoking-related lung cancer happens in women, so there’s certainly an association with female sex,” said Jaclyn LoPiccolo, a medical oncologist at Dana-Farber Cancer Institute who co-authored the mutation study.

She added, “Nonsmoking-related lung cancer is also more common in people of East Asian descent, but whether that’s a genetic or environmental association, we don’t yet know.”

These Cancers Are Often Diagnosed Late

Also read: Pope Leo XIV Resumes Daily Activities After Lung Cancer Surgery: How Recovery Looks Like After Lung Lobe Removal

People who have never smoked may not recognise a persistent cough or other respiratory symptoms as signs of lung cancer. Doctors may initially consider more common explanations if the patient has no smoking history.

Never-smokers are often diagnosed late at more advanced stages of the disease because their doctors initially consider lung cancer to be less likely.

Haiying Cheng, a medical oncologist at Montefiore Einstein Medical Center in New York, said the stigma surrounding the disease can compound the problem. “A cancer diagnosis should never become a judgment about a patient,” Cheng said.

She added that clinicians need to consider assumptions beyond smoking when it comes to lung cancer and focus on the patient’s risk profile and tumour biology.

Lin is receiving antibody therapy targeting a cancer-driving mutation. He had a positive response to treatment.

“The treatment has done wonders for me,” he said. “When I was a medical student or resident, I would have never thought a Stage 4 lung cancer patient could be very productive and have a high quality of life almost two-and-a-half years after diagnosis.”

In the United States, the US Preventive Services Task Force recommends annual low-dose CT screening for adults aged 50 to 80 who have a smoking history. People who have never smoked are not included in these recommendations.

As researchers dig deeper into lung cancer chances in non-smokers, there is growing interest in different screening recommendations. Taiwan, for example, has a national early-detection programme offering low-dose CT scans to non-smokers with a family history of lung cancer.

Lin has urged his own sons to consider screening at a younger age. “I’ve got two sons, and I told them, ‘When you hit 45 or even 40, think about getting screened,’” he said.

Many women in their forties come to my clinic with joint pain they have lived with for months, assuming it is part of getting older. World Arthritis Day is a good time to look at what changes in a woman's joints after 40 and why it pays to act early.

Why Does The Risk Rise After 40?

The biggest shift is hormonal. Oestrogen helps regulate inflammation and protects cartilage, bone and muscle. As levels fluctuate during perimenopause and fall after menopause, the joints lose part of that protection. A 2024 review in the journal Climacteric named this pattern the musculoskeletal syndrome of menopause, estimating that more than 70% of women experience joint or muscle symptoms during the transition and about one in four find them disabling.

Lower oestrogen also speeds up the loss of muscle and bone. When the thigh muscles weaken, the knee absorbs more shock with every step, which is one reason knee osteoarthritis becomes more common in women at this stage. Osteoarthritis, the gradual wear of the cartilage cushioning the bones, commonly affects the knees, hips, hands and spine. Old injuries, excess weight, and family history increase the risk.

Women are also two to three times more likely than men to develop rheumatoid arthritis, an autoimmune condition in which the immune system attacks the joint lining. It most often begins between the ages of 30 and 60.

Which Signs Should You Watch For?

One simple check is how long your joints stay stiff in the morning. Stiffness and pain that increases with movement is typical of osteoarthritis. Stiffness even with rest, especially with swelling in the small joints of both hands or wrists, suggests inflammatory arthritis and needs prompt assessment. Other signs include pain while climbing stairs or getting up from the floor, a grating feeling in the knee, firm bony swellings on the finger joints and tiredness out of proportion to your activity.

Not every ache after 40 is arthritis. Menopause-related pain, for instance, tends to move around the body. An examination, an X-ray, and simple blood tests can tell these conditions apart, so avoid self-diagnosis.

How Can You Protect Your Joints?

• Strength training: Muscle-strengthening exercise at least twice a week, focused on the thighs and hips, takes load off the knees.
• Low-impact activity: Walking, swimming, and cycling keep joints mobile without straining them.
• Weight: A study of adults with knee osteoarthritis found that every kilogram lost takes about four kilograms of load off the knee with each step.
• Diet: Get enough protein and calcium, and ask your doctor whether you need a vitamin D test.
• Daily habits: If your knees already hurt, limit deep squatting and long hours sitting cross-legged on the floor, wear supportive footwear, and avoid smoking.

When Should You See A Doctor?

Consult an orthopaedic specialist if joint pain or stiffness lasts beyond a few weeks or affects daily tasks. In rheumatoid arthritis, early treatment can slow the disease and prevent permanent joint damage. A suddenly hot, red, swollen joint with fever needs same-day attention, as it may signal infection.

Arthritis does not have to come with turning 40. Women who notice the early signs, keep their muscles strong, and see a doctor in time can stay active and independent well into later life.

By Dr Saurabh Bansal, Consultant Orthopaedic Surgeon, PB Health

Holding urine occasionally, such as during a long meeting or traffic jam, is generally not harmful for most healthy adults. However, repeatedly delaying urination for extended periods may affect urinary health, particularly in people who are prone to urinary tract infections (UTIs) or have existing bladder problems.

What Happens When You Hold Urine for Too Long?

When urine remains in the bladder for too long, it can become uncomfortable and may contribute to bladder overdistension. In some individuals, particularly those with underlying urinary retention or bladder dysfunction, regularly postponing urination may worsen existing problems.

While holding urine does not directly cause a UTI in every case, incomplete bladder emptying can increase the risk of infection.

Also read: Are People With CKD At Higher Risk Of Dementia And Cognitive Problems?

Why You Should Not Reduce Water Intake to Avoid Bathroom Break

People who work long hours or commute frequently should try to respond to the urge to urinate rather than routinely suppressing it.

Maintaining adequate hydration is equally important, as deliberately drinking less water to avoid bathroom breaks can lead to concentrated urine and may increase the risk of certain urinary problems like concentrated urine leading to crystallization and stone formation.

When Should You Seek Medical Advice?

If you experience persistent urgency, burning during urination, lower abdominal discomfort, difficulty passing urine or blood in the urine, seek medical advice. Developing regular bathroom habits and ensuring convenient access to washrooms can help support long-term urinary health.

It is also important to recognise when urinary symptoms may indicate a more serious problem. Inability to pass urine despite a strong urge, particularly when accompanied by severe lower abdominal pain or swelling, requires urgent medical attention.

Fever, chills or pain in the back or side alongside urinary symptoms may indicate a kidney infection and should be assessed promptly. Avoid assuming that such symptoms are simply the result of holding urine for too long.

By Dr. Vikram Kalra, Principal Director - Nephrology and Kidney Transplant, Aakash Healthcare Multi Speciality Hospital, Dwarka