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.

Ramzan, the holiest month in Islam, marked by dawn-to-dusk fasting, poses health risks for people with diabetes. Health experts urge patients to consult their doctors before observing the fast.

Ramzan is a period of intense spiritual reflection, self-discipline, and devotion for Muslims worldwide. During the month-long fasting period, the believers refrain from eating and even drinking (including water), from dawn to sunset.

The faithful eat a modest meal (sehri) before the first light of dawn to provide energy for the day. The fast is broken at sunset, traditionally starting with dates and water, followed by a larger meal (iftar).

According to health experts, for individuals whose diabetes is well controlled, fasting may be possible with proper adjustments.

"Diabetes requires regular monitoring, balanced meals, and timely medication. When eating patterns change during Ramzan, blood glucose levels can fluctuate. That is why I strongly recommend consulting your doctor before you plan to fast,” Dr. Saptarshi Bhattacharya, Senior Consultant, Endocrinology, Indraprastha Apollo Hospitals, told HealthandMe.

The expert advised people not to skip sehri, and to include complex carbohydrates such as whole grains, along with protein like eggs, dal, or curd, and plenty of fluids to help maintain stable glucose levels throughout the day.

At iftar, avoid overeating. Start with light, balanced food and limit fried items, sweets, and sugary drinks, as these can cause a sudden spike in blood glucose, Dr. Bhattacharya said.

Type 2 Diabetes patients with good glycemic control, lifestyle management, or stable oral medications can fast safely.

However, those on multiple insulin doses, with complications, or with poor control are considered moderate to high risk, Dr. Kartik Thakkar, Consultant Medicine, Ruby Hall Clinic, told HealthandMe.

The health expert also noted that most Type 1 diabetes patients are considered high risk, especially those with brittle diabetes, frequent hypoglycemia (low blood sugar), or a history of diabetic ketoacidosis (DKA). Many are medically advised not to fast, particularly if glucose control is unstable.

Children and adolescents with type 1 diabetes are considered high risk and are usually advised against fasting due to the unpredictable nature of insulin requirements.

Who Should Avoid Fasting Altogether?

• People with a history of severe hypoglycemia in the last 3 months;
• Recurrent hypoglycemia;
• Advanced kidney disease;
• Elderly patients with frailty; and
• Pregnant women with diabetes

Dr. Thakkar said that such individuals fall into the very high-risk category and are medically exempt from fasting.

The expert also suggested clinical tests to determine whether a diabetic patient is fit to fast. These include:

• Glycemic control (HbA1c levels)
• Duration of diabetes (long-standing diabetes can increase complication risk)
• Presence of complications (neuropathy, nephropathy, cardiovascular disease)
• Kidney function and hydration status

What Warning Signs Should Prompt Breaking The Fast Immediately?

A diabetic patient must break the fast if:

• Blood glucose <70 mg/dL (3.9 mmol/L)
• Blood glucose >300 mg/dL (16.7 mmol/L)
• Severe dizziness or fainting
• Confusion or blurred vision
• Persistent vomiting
• Symptoms of dehydration (extreme thirst, very low urine output)
• Chest pain or breathlessness

A new study has shown that people who survived COVID-19 infections are more likely to develop obstructive sleep apnea (OSA) for years after the infection with the SARS-CoV-2 virus.

OSA is a common and serious sleep disorder that causes the throat muscles to relax and block the airway, resulting in fragmented, nonrestorative sleep, low blood oxygen, and loud snoring.

The February 2026 study, published on the preprint server medRxiv, found that people with both severe and non-severe COVID infections are at higher risk of developing sleep apnea and other sleep issues for 4.5 years.

"SARS-CoV-2 infection is independently associated with increased risk of new-onset OSA. These findings support targeted screening in post-COVID populations,” said Sagar Changela, Department of Radiology, Albert Einstein College of Medicine, in the paper.

What The Study Found

Although an infection with the SARS-CoV-2 virus has been associated with long-term respiratory and neurological conditions, its role in new-onset OSA remains unclear.

The retrospective study, which has not been peer-reviewed, involved 910,393 patients. The results showed that patients hospitalized due to COVID were 41 percent at risk of new onset of OSA.

One-third of people with mild COVID infection, who weren't hospitalized, also suffered from sleep issues.

The researchers also linked OSA to cardiovascular, metabolic, and cognitive morbidity. The team found that OSA increased the risk of heart failure and pulmonary hypertension among hospitalized COVID patients, compared to those with mild infections.

On the other hand, the non-hospitalized COVID patients were significantly more likely than controls to develop obesity.

Further analyses showed that the risk of new-onset OSA was higher in hospitalized COVID patients with asthma and those who were younger than 60 years. Notably, women were also found at greater risk than men, while vaccination status did not vary by risk.

According to the team of researchers, the major factors for OSA among COVID patients are low-grade systemic inflammation after a SARS-CoV-2 infection that reduces upper-airway neuromuscular control.

In addition, the higher levels of inflammatory cytokines often seen in long-COVID patients can also affect respiratory drive and upper-airway stability -- key factors for OSA.

What Is Sleep Apnea?

Sleep apnea is a serious sleep disorder where a person's airway can collapse completely or partially. It causes breathing lapses during sleep, and the body stops breathing many times while an individual is asleep. It also weakens throat muscles, leading to airway collapse during sleep. The decrease in oxygen saturation can also lead to death.

While OSA is the most common type of the sleep disorder, other types include central sleep apnea and complex sleep apnea.

Obesity is the major cause of this disorder, and loud snoring is the most common symptom. The person suffering from the condition feels tired, even after getting adequate sleep.

Treating sleep apnea is key to preventing long-term health complications such as cardiovascular disease, hypertension, diabetes, stroke, and increased mortality.

CPAP machines, oral appliances, and lifestyle modifications are common and effective treatment measures.

For decades, diabetes conversations have revolved around diet, weight and genetics. While these remain central, growing medical evidence shows two often ignored factors play a powerful biological role in blood sugar control: stress and sleep.

Dr Narendra BS, Lead Consultant in Endocrinology and Diabetology at Aster Whitefield, Bengaluru, recently wrote for NDTV explaining that these are not minor lifestyle irritants but metabolic triggers.

According to him, poor sleep and chronic stress “create a biological environment that puts us at risk for developing type 2 diabetes or make it harder to control blood sugar if we already have the condition.”

How Stress Raises Blood Sugar

When the body senses danger, it activates its major stress systems including the hypothalamic pituitary adrenal axis and the sympathetic nervous system. These release cortisol and adrenaline, hormones designed to help survival.

They rapidly increase blood glucose so the body has instant energy. This is useful during emergencies but harmful when stress becomes constant.

“Continuous stress from work pressure, caregiving or anxiety reduces the body’s insulin sensitivity,” Dr Narendra explains. Over time, cells stop responding properly to insulin and glucose levels rise.

Long term studies now link persistent stress patterns to insulin resistance and a higher risk of diabetes. In simple terms, even if diet remains unchanged, chronic emotional strain can gradually push the body toward metabolic disease.

The Hidden Damage From Poor Sleep

Sleep disturbance works just as strongly against blood sugar regulation.

Sleep restriction, irregular schedules and fragmented sleep impair glucose tolerance, sometimes within days. Research shows that even partial sleep loss raises fasting glucose and insulin levels. Over time, this increases HbA1c and diabetes risk.

“When you don’t get good sleep, your body is simply not as efficient at handling sugar,” he notes.

The problem worsens because stress and sleep feed each other. Stress disrupts sleep, sleep deprivation increases stress hormones, and both promote unhealthy habits such as late night snacking, skipping exercise and excess caffeine intake.

Doctors in India increasingly link this cycle to urban lifestyles and rising diabetes prevalence.

Encouragingly, The Damage Can Be Reversed

The positive takeaway is that these effects are modifiable. Improving sleep duration and reducing stress measurably improves insulin sensitivity.

Sleep extension trials have shown improvements in glucose metabolism. Stress management programs have lowered fasting glucose and HbA1c levels.

Because the science is clear, Dr Narendra recommends that diabetes care must include mental and sleep assessment. Screening for insomnia, anxiety and depression should be routine in metabolic clinics.

What Patients Can Do

Sleep should be treated like medicine. Adults should aim for 7 to 8 hours of consistent sleep, maintain fixed bedtimes and avoid screens for at least an hour before bed. Shift workers may require specialist guidance due to circadian rhythm disruption.

Stress management can begin with simple practices. Deep breathing, mindfulness and short cognitive exercises can lower daily cortisol levels. Therapy and medication may help when anxiety or depression is present.

Physical activity is equally important. Regular exercise improves insulin response and prevents excessive stress reactions. Even a short walk after meals helps reduce blood sugar spikes.

A New Approach To Diabetes Care

Healthcare providers are encouraged to actively discuss sleep and psychological health during treatment. A combined approach using lifestyle modification, mental health care and medication provides better results than focusing on diet alone.

“Blood sugar is not just a number on a test,” Dr Narendra emphasizes. “It reflects lifestyle, biology and psychology. Addressing sleep and stress tackles a major but often neglected contributor to poor control.”

In short, managing diabetes is no longer only about what is on the plate. It is also about what happens at night and what weighs on the mind.