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.

BBC News presenter Maryam Moshiri has opened up about her experience of living with an incurable blood cancer for the past two years.

Moshiri, 49, was diagnosed with Polycythemia Vera (PV) in November 2024. The condition affects the bone marrow and causes the blood to become thicker than normal.

While undergoing treatment, Moshiri has continued to work and has spoken about the challenges of managing her condition alongside her career.

“I love what I do. I love being where the story is. I don’t want to allow blood cancer to stop me from doing my work,” she told The Times.

Maryam Moshiri Opens Up About Living With Blood Cancer

Moshiri’s treatment involves having blood removed to reduce the concentration of red blood cells, a procedure that can leave her feeling exhausted.

She has also opened up about the challenges of continuing to work while experiencing fatigue related to her cancer treatment.

“I was working 14-hour days, constantly on air, constantly having to think on my feet, and holding it together, despite the fact that I had this chronic tiredness and fatigue,” she was quoted as saying.

“When you’re doing live news, you have this rush of adrenaline, and you just have to get on with it.”

Moshiri, who is a mother of three children aged 13, 11 and 9, also highlighted how she has struggled with constant fatigue while managing family life.

What Is Polycythemia Vera?

Polycythemia vera is a disorder in which the bone marrow produces excessive amounts of blood cells. In PV, the major problem is an overproduction of red blood cells.

An increased number of red blood cells means a higher proportion of cells are circulating in the blood. This can make the blood thicker and increase the risk of blood clots, stroke and heart attack.

Doctors therefore pay close attention to a patient's hematocrit, which represents the proportion of blood made up of red blood cells.

One of the major treatment goals is to keep hematocrit below 45%, which helps reduce cardiovascular risks.

How Is Polycythemia Vera Treated?

One of the traditional ways of controlling PV is removing some blood. The procedure, called phlebotomy, involves taking blood from a vein to reduce the number of circulating red blood cells and bring the hematocrit level down.

For some patients, this can become a recurring procedure. They may need repeated blood draws even while receiving standard treatment. This treatment burden is one reason a new drug for PV has attracted attention.

FDA Approves Drug for Polycythemia Vera

Late last month, the US Food and Drug Administration (FDA) approved Mimrylo (rusfertide) for adults with polycythemia vera (PV).

The drug is the first approved treatment for PV that mimics hepcidin, a naturally occurring hormone that regulates iron in the body.

The approval is particularly significant for patients whose disease remains inadequately controlled despite existing treatment and who need frequent blood-removal procedures.

“People living with polycythemia vera have long faced the challenge of managing a chronic blood disorder with frequent blood draws,” said Tanya Wroblewski, Director of the Division of Nonmalignant Hematology at the FDA's Center for Drug Evaluation and Research.

The FDA granted priority review and approved the drug to Takeda Pharmaceuticals America.

Air pollution has now become an inevitable aspect in many Indian cities, whether it is vehicular emissions, dust from construction activities, industrial pollutants, or smoke from burning crops. Some of the worst pollutants from the health point of view are those comprising PM2.5 (particulate matter 2.5).

Particulate matter 2.5 means the fine particulate matter measuring 2.5 microns in diameter or smaller, which is roughly 30 times smaller than the diameter of a human hair.

Due to their microscopic size, these particles can enter deep inside the lungs and even the blood stream. The WHO and the IARC have labeled outdoor air pollution and particulate matter as a carcinogen, which implies that it can lead to increased risk of cancer.

How does PM2.5 increase cancer risk?

Long-term exposure to PM2.5 is responsible for causing inflammation and oxidative stress within the body. Inflammation and oxidative stress will eventually result in DNA damage leading to an abnormal growth of cells.

The link between exposure to PM2.5 and cancer is well-documented, with lung cancer being the most established one, while others are still under investigation. According to WHO guidelines, long-term exposure to PM2.5 is linked to higher lung cancer mortality rates, even at lower concentrations.

This is highly relevant to India because air pollution in many Indian cities exceeds WHO recommendations.

Also read: Exposure To Air Pollution May Harm Male And Female Fertility, Expert Reveals

Practical ways to reduce your exposure

Even though individual measures may not solve the problem of air pollution completely, they do help to minimize personal exposure.

1. Keep an eye on the daily air quality

Monitor the AQI index before engaging in any outdoor physical activity and on polluted days, try to reduce the amount of time you spend outdoors.

2. Avoid pollution peaks

Early morning and late evening are typically times when pollution level is high. Plan your outdoor activities on less polluted days.

3. Use an N95 mask

When going out, especially commuting, during the days of high pollution use an N95 mask that helps to filter fine particles.

4. Improve indoor air quality

Close windows during heavy air pollution and install a HEPA filter air purifier if needed, especially for kids, elderly people and those who suffer from lungs diseases.

5. Reduce indoor pollution sources

Do not smoke indoors; use less incense and mosquito coil indoors, and make sure there is a good ventilation system in the kitchen when you cook.

6. Take care of general lung health

Never smoke, keep physically active during the days of decent air quality, and eat nutritious food with lots of fruit and veggies.

The bigger picture

Protecting yourself from the health risks of PM2.5 can be done by both individual means and also collective efforts. More sustainable modes of transport, better emission control policies, improved waste disposal facilities, and sound urban planning practices will become necessary eventually. In the meantime, we only have our knowledge and preventive steps to safeguard our health.

By Dr. Reshma Puranik, Cancer Physician, MOC Pune

Robotic thyroid surgery is a minimally invasive technique in which the surgeon uses robotic instruments to remove part or all of the thyroid gland. Unlike conventional surgery, which requires an incision on the front of the neck, the robotic approach uses small incisions hidden in the armpit and chest to access the thyroid, thereby avoiding a visible neck scar while maintaining surgical precision.

However, one of the biggest misconceptions about robotic surgery is that the robot performs the operation independently. It does not. Every movement is completely controlled by the surgeon, who sits at a console and guides the robotic instruments with exceptional precision. The technology essentially extends the surgeon's capabilities by providing a high-definition, three-dimensional and magnified view of the surgical field, along with highly flexible, wristed instruments.

Precision beyond the cosmetic advantage

The absence of a visible neck scar is undoubtedly a major advantage, especially for patients concerned about their appearance. However, robotic thyroid surgery is far more than a cosmetic procedure.

The robotic system provides high-definition, magnified 3D vision and wristed instruments that allow meticulous dissection around delicate structures such as the recurrent laryngeal nerves and parathyroid glands. This precision helps preserve these vital structures, minimizing the risk of nerve injury, voice changes, and parathyroid dysfunction. Tremor filtration and enhanced dexterity further improve surgical accuracy.

Together, these advantages result in less tissue trauma, reduced postoperative pain, faster recovery, and excellent functional and cosmetic outcomes.

Also read: Why Your Thyroid Test Results Can Vary Between Labs?

Is robotic surgery suitable for everyone?

Not every thyroid patient is a candidate for robotic surgery. Patients with thyroid nodules, selected early thyroid cancers and certain benign thyroid enlargements may be considered after detailed evaluation.

So, patients with very large goitres, advanced thyroid cancers involving surrounding structures or certain complex medical conditions may be better suited to conventional open surgery.

Therefore, patient selection remains one of the most important aspects of robotic thyroid surgery.

There is a common belief that robotic thyroid surgery is meant only for young patients who want to avoid a neck scar. Is that true?

No. While the absence of a visible neck scar is certainly an attractive cosmetic benefit, it is not the main advantage of robotic thyroid surgery. The real strength of robotic technology lies in its precision, which minimizes tissue trauma, reduces postoperative pain, and promotes faster recovery.

Most patients require pain medication for only 48–72 hours after surgery. These benefits are particularly valuable for elderly patients, who often recover more comfortably and can avoid prolonged use of painkillers. Therefore, age is not a criterion for robotic thyroid surgery. Suitability depends on the nature of the thyroid disease and careful patient selection.

Also read: Breaking Down Weight Gain: The Role Of Hormones And Stress- Know What Really Works For Effective Management

What about voice changes?

One of the major concerns after thyroid surgery is voice alteration, as the recurrent laryngeal nerve, which controls the vocal cords, lies in close proximity to the thyroid gland. The magnified 3D view and wristed robotic instruments enable meticulous identification and preservation of this delicate nerve during surgery.

Although no surgical technique can completely eliminate the risk of complications, the enhanced precision and superior visualization offered by robotic surgery help minimize the risk of nerve injury while ensuring careful preservation of other vital structures.

Is recovery faster?

Recovery after robotic thyroid surgery varies from patient to patient. Most patients are able to walk within a few hours after surgery and are discharged within one to two days. In our experience, pain is usually mild, with most patients requiring pain medication for only 48–72 hours.

As there is no incision on the front of the neck, swallowing and neck movements are often more comfortable during recovery. Reduced postoperative discomfort can be particularly beneficial for elderly patients, in whom prolonged use of pain medication may be undesirable.

Growing adoption in Eastern India

Our Department of Advanced Robotic Surgery has emerged as one of the highest-volume centres for robotic thyroid surgery in Eastern India, currently performing approximately 3–4 robotic thyroid procedures every month. As awareness among patients and referring physicians continues to grow, this number is steadily increasing.

Our experience has been highly encouraging, with no permanent voice changes or major complications reported among our robotic thyroid surgery patients to date. These results reinforce an important message: while robotic technology is a powerful tool, its success ultimately depends on careful patient selection and the experience of the surgical team.

Thyroid surgery need not be a cause for fear. Modern surgical techniques have made treatment safer, more precise, and increasingly patient-friendly. For appropriately selected patients, robotic thyroid surgery offers the advantages of exceptional surgical precision, reduced tissue trauma, faster and more comfortable recovery, and the significant cosmetic benefit of avoiding a visible neck scar.

By Dr. S. K. Bala, Surgical Oncologist and Robotic Surgeon, CK Birla Hospitals, CMRI