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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.
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.
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."
Long-term consumption of these drinks may gradually affect digestion, liver detoxification, and overall metabolic health, making moderation necessary.
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.
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:
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.
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.
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She came to the hospital because of a cough that would not go away. The cough was eventually found to be nothing serious. But her CT scan revealed something unexpected — a 12 mm nodule in the outer part of her right lung.
She had never smoked. She felt completely well.
Yet that tiny shadow raised a big question: was it an old tuberculosis scar, a harmless growth, or an early lung cancer?
A CT scan can show us that a nodule is there. It cannot always tell us what it is.
This is an increasingly familiar situation. As CT scans have become more widely used, particularly after the COVID-19 pandemic, doctors are finding small lung nodules in people being scanned for entirely different reasons. Most turn out to be benign. Some, however, need closer assessment.
India has another challenge. Tuberculosis and its scars are common, and a lung shadow can sometimes be attributed to TB without tissue confirmation. While treating tuberculosis promptly is important, assuming that every suspicious nodule is TB can occasionally delay the diagnosis of something else, including cancer.
The answer, when appropriate, is to obtain a tissue sample.
Traditionally, a small nodule deep in the lung could be difficult to reach. A needle biopsy through the chest can be effective but carries a risk of a collapsed lung. Conventional bronchoscopy is excellent for the larger airways but becomes more challenging as the target gets smaller and farther towards the edge of the lung. Surgery may sometimes be necessary.
Navigation bronchoscopy uses the patient's CT scan to create a three-dimensional map of the airways and guide a thin catheter towards the nodule. Cone Beam CT adds real-time three-dimensional imaging during the procedure, allowing the doctor to check where the instruments are in relation to the lesion before taking the biopsy.
In simple terms, navigation helps us find the way; Cone Beam CT helps us confirm we are there.
The tissue can then be examined immediately where appropriate, helping determine whether the sample is adequate and whether additional material is needed for advanced testing.
Importantly, not every nodule needs a biopsy. Many are best managed through carefully planned follow-up scans. The decision depends on the nodule's size and appearance, previous scans, and the patient's overall risk.
For patients, the message is reassuring: a lung nodule does not mean cancer. But it should not be ignored either.
Keep previous scans. Ask what the likely possibilities are. Understand why your doctor recommends surveillance or biopsy — and make sure the follow-up happens.
Today, advanced bronchoscopy is helping doctors turn a worrying shadow into something much more useful: an answer.
(By Dr Shyam Krishnan, Intervention Pulmonologist, CMRI)
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Dry cough and breathing difficulty aren’t always caused by asthma, COPD, or infections. They can also be signs of interstitial lung disease (ILD), a group of lung conditions that can cause inflammation and scarring and, in some cases, progressive loss of lung function.
ILD can go unnoticed in its early stages because its symptoms are often mistaken for more common respiratory conditions. By the time a patient undergoes a CT scan and reaches an ILD clinic, significant lung scarring may have already developed — and some of that damage may be irreversible.
A Global Burden of Disease Study 2023 analysis, published in December 2025, estimated that 4.58 million people were living with ILD and pulmonary sarcoidosis worldwide in 2023, with 112,650 deaths attributed to the conditions that year.
“The true global burden of ILD is higher than currently reported, particularly in underserved populations and low- and middle-income countries,” Prof. Marlies Wijsenbeek-Lourens, Pulmonologist and Head of the Center for Interstitial Lung Diseases and Sarcoidosis at Erasmus University Medical Center, Netherlands, told HealthandMe.
The global expert said most available epidemiological data come from Europe, North America, Japan, South Korea and Australia, where access to specialist care, multidisciplinary diagnosis and high-resolution CT imaging is generally more available.
“As a result, large parts of Africa, South America, South and Southeast Asia remain underrepresented in current estimates. In these regions, more limited access to diagnostic facilities, fewer ILD specialists and under-recognition of disease undoubtedly result in substantial underdiagnosis.”
Even in high-income countries, she added, some patients with ILD likely remain undiagnosed because symptoms such as breathlessness and cough are often attributed to more common conditions.
ILD is not a single disease but a group of more than 200 lung conditions. The disease affects the interstitium, the tissue surrounding and supporting the lungs’ air sacs, or alveoli. In ILD, this tissue can become inflamed and/or scarred.
As scarring progresses, the lungs can become stiffer, making it harder for them to expand and reducing the efficiency of oxygen transfer. As the disease progresses, the lung shrinks, making it difficult for the patient to breathe.
According to Prof. Marlies, there is a rise in ILD diagnoses due to several factors, such as:
Some forms of ILD can be treated more effectively when identified early, before permanent lung damage occurs.
“Unfortunately, many patients still reach an ILD specialist late. Breathlessness and cough may initially be treated as asthma, infection or sometimes even tuberculosis. By the time a CT scan is done and the patient reaches an ILD clinic, significant scarring may already have developed,” Dr Asmita Mehta, Professor and Head, Department of Respiratory Medicine at Amrita Institute of Medical Sciences, Kochi, told HealthandMe.
“A dry cough and gradually progressive breathlessness lasting for more than three months, particularly breathlessness while walking or climbing stairs, should raise suspicion of ILD rather than simply being attributed to asthma, infection or ageing,” she added.
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Doctors should think of ILD especially when these symptoms do not improve with usual treatment, when fine crackling sounds are heard in the lungs, or when oxygen levels fall during walking.
It is also important to ask about joint pain, skin changes, dry eyes or mouth, and exposure to birds, mould, biomass smoke or occupational dust. Sometimes the clue to ILD is outside the lungs, the expert said.
Pre-existing ILD was associated with worse outcomes during COVID-19. Now, six years later, some patients who had severe COVID-19 also continue to show persistent lung abnormalities.
“The reassuring part is that not every abnormal CT after COVID means progressive lung fibrosis. In many patients, the lung changes gradually improve or remain stable. Some patients who had very severe COVID, prolonged ICU admission, or required ventilation may be left with persistent scarring and may need longer follow-up,” Dr Asmita said.
Common ILD diagnoses seen in India include connective tissue disease-associated ILD (CTD-ILD), hypersensitivity pneumonitis (HP), idiopathic pulmonary fibrosis (IPF), sarcoidosis and idiopathic nonspecific interstitial pneumonia (NSIP).
Dr Asmita said that, apart from idiopathic pulmonary fibrosis, ILD related to autoimmune diseases and environmental exposures is also commonly seen in India. These exposures can include birds, mould, biomass smoke and certain occupations.
Epidemiological reviews estimate the overall prevalence of ILD in India to range between 49.0 and 98.1 per 100,000 people, with an annual crude incidence rate of 10.1 to 20.2 per 100,000 population.
India is also building a larger national evidence base through the ICMR-led Indian Network of Pulmonary Fibrosis (INPF) registry.
“We therefore need not only earlier diagnosis, but better awareness, affordable treatment, wider access to ILD specialists and stronger advanced-care and transplant programs,” Dr Asmita said.
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Humans and most mammals have two sex chromosomes, X and Y. Females typically have two X chromosomes (XX), while males typically have one X and one Y chromosome (XY). As men age, many of their cells gradually lose the Y chromosome, due to a common genetic change.
Research has shown that cancer incidence and mortality rate are more among men than women. A new study may offer clues as to why.
Researchers from the University of Arizona found that loss of the Y chromosome in men’s tissues could create conditions that allow cancer to develop.
The research, published in JCI Insights, found that Y chromosome loss creates a pre-neoplastic field effect — a hidden zone of genetic vulnerability in normal-appearing tissue that may provide fertile ground for cancer development.
Also read: US Cancer Death Rates Fall For Men, Women: Lung Cancer Progress Drives Decline
Previous studies have linked loss of the Y chromosome in blood cells to an increased risk of disease. The new study systematically profiled Y chromosome loss across normal, precancerous and cancerous tissues from 11 major human organs.
“We were able to show that the loss of the Y chromosome is found in normal-appearing tissues adjacent to a tumor,” said physician-scientist Dr. Dan Theodorescu of the University of Arizona Cancer Center.
“That finding is what makes this discovery so exciting. It suggests we may be looking at one of the earliest signposts of cancer forming.”
The team analyzed 1,000 tissue samples from 405 men, using an automated fluorescent imaging system to examine more than 4.3 million individual cell nuclei and measure the ratio of Y to X chromosomes.
In one part of the study, researchers created detailed maps of bladder tissue removed during cancer surgery.
The maps showed that Y chromosome loss increased as tissue progressed from normal tissue to early abnormal cells and then to cancer.
Y chromosome loss in normal-appearing tissue was highest in samples from colon, rectal, esophageal, pancreatic and lung cancers.
“We are now thinking of this as a gradient, similar to a hillside that slowly gets steeper,” Theodorescu said. “The closer the tissue is to a cancer, the more Y chromosome loss we see. That gradient could one day help doctors suspect trouble in biopsies that miss a smaller cancer.”
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Theodorescu’s previous research examined how loss of the Y chromosome in cancer cells can help them evade the immune system. This may help explain why Y chromosome loss has been associated with higher mortality from certain carcinomas.
The Y chromosome spans more than 59 million DNA base pairs and accounts for almost 2% of the DNA in human cells. It contains roughly 70 to 200 genes involved in protein production.
The chromosome contains genes that play important roles in male sex development and fertility, including sperm production.
Beyond reproduction, research suggests that the Y chromosome can influence immune and inflammatory responses in men, potentially affecting susceptibility to certain diseases.
Globally, cancer is diagnosed more often in men than in women, with men having roughly a 25% higher incidence rate. Men also account for a greater share of cancer deaths worldwide.
Some of the most common cancers affecting men include prostate, lung, colorectal and skin cancers. Early detection and appropriate screening can improve the chances of successful treatment for several types of cancer.
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