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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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In India, air pollution is no longer just a winter problem. While pollution levels peak during the colder months, poor air quality has increasingly become a year-round concern, with Delhi-NCR continuing to experience severe pollution episodes.
As air quality deteriorates in the national capital region, schools have now been forced to shift classes online, keeping children indoors and increasing their screen time.
Beyond its physical effects, experts warned that prolonged exposure to pollution, combined with disruptions to children's everyday lives, can also affect their behaviour, emotional well-being and social development.
While the respiratory and developmental effects of air pollution are well documented, they warned that its impact may extend to children's emotional well-being, behaviour and social development.
Reduced outdoor activity, disrupted social interactions and greater dependence on digital platforms could add to the psychological stress children experience.
Air pollution should not be viewed as an isolated exposure when examining its impact on children's mental health, said Dr. Pradeep B.S., a Professor of Epidemiology and Deputy Medical Superintendent at the National Institute of Mental Health and Neuro Sciences (NIMHANS) in Bengaluru.
"Air pollution is a macro-level effect. If we reduce it to individual-level effects, we are scientifically wrong," he told HealthandMe on the sidelines of the 11th Together Against Stigma (TAS) Conference, held in the national capital.
He said air pollution is associated with several broader changes, including increased traffic, population growth, climate disturbances and unpredictable weather patterns. Together, these can have a silent effect on people's psychological well-being, including that of children and adolescents.
The effects may not always be direct. Respiratory and gastrointestinal problems, for instance, can prevent children from going outdoors and participating in activities. Losing the opportunity to play can itself become a source of distress.
He also pointed to urbanisation and road expansion, which not only contribute to pollution but also reduce green spaces, playgrounds and community recreational areas. The combination can limit children's opportunities to play, interact and socialise.
Dr. Pallab K. Maulik, the Director of Research at The George Institute for Global Health India said air pollution is one of the contributors to mental health concerns, with both Indian and international research examining the association.
He told HealthandMe that pollution and environmental disasters can create anxiety and stress among children, particularly those whose everyday lives are disrupted by these conditions.
Citing an example from one of his study sites, he recalled speaking to a child living in a slum area whose home gets flooded whenever municipal tankers wash the streets. The child has to spend two days drying her books after the water enters the house.
Dr Pallaub also referred to children in the Sundarbans who regularly experience flooding and salinity-related problems.
He said some adolescents are now using platforms such as adolescent parliaments to bring their concerns to local administrators. While children are becoming more aware of environmental challenges, he said, much more needs to be done to understand how environmental changes affect their mental health.
Dr Syed Hubbe Ali - Health Specialist (RMNCHA) at UNICEF highlighted another possible consequence of pollution-related restrictions on outdoor activities: increased screen exposure among children and adolescents.
When children cannot go outside, they tend to spend more time indoors, often turning to mobile phones, social media and online content. This can create a cycle of screen dependence, he explained.
He described how the pursuit of dopamine, associated with the brain's reward system, can encourage children to keep scrolling through social media content.
The cycle can become more complicated when children begin posting content and seeking validation through likes and engagement.
"Once you start developing your roles, the next stage comes when you see how many likes I got. I got the likes, I don't get the likes. Then the anxiety, you know, it starts," Dr Ali told HealthandMe.
He explained that not receiving the expected engagement can cause distress and, in some cases, contribute to depressive feelings and risky behaviour.
Dr Ali also raised concerns about children spending more time on screens for online learning. Referring to an NCERT survey conducted after the COVID-19 pandemic among 3.7 lakh children, he said only 51% were able to understand online content.
He suggested that learning methods need to move beyond conventional online teaching and incorporate more games and interactive approaches to improve children's engagement.
Dr Pradeep emphasised that the impact of pollution cannot be separated from the wider changes taking place in children's surroundings.
Reduced access to green spaces and recreational areas can affect opportunities for physical activity, social interaction and play. When children are unable to participate in these activities, the effects can extend beyond physical health.
Dr Ali also highlighted the importance of outdoor activities and sunlight exposure in children's everyday lives. He said keeping children indoors for prolonged periods can increase their dependence on digital platforms as a source of entertainment and stimulation.
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Gait, or an individual's walking pattern, is an important marker of overall health, reflecting neurological integrity, musculoskeletal function and cognitive status. Although walking may seem effortless, people often dismiss changes in their gait as signs of tiredness or ageing.
Losing balance while walking can sometimes be attributed to fatigue, dehydration or a momentary lapse in attention. However, recurrent or unexplained balance problems can also indicate an underlying neurological condition and should not be ignored, experts warned.
Dr Gaurav Batra, Principal Consultant, Neurosurgery, Yashoda Super Speciality, said individuals experiencing instability, changes in their walking pattern or more frequent tripping than usual should seek medical evaluation.
"Walking seems so natural that it is often taken for granted. However, it involves the brain, nerves, muscles, eyes and the balance system in the inner ear working in unison," he told HealthandMe.
"When there is a disorder in one of these systems, the way a person walks can be affected, which is exactly why the type of imbalance becomes an important consideration. One person may feel like they are being dragged in a particular direction," the expert added.
New, persistent or worsening balance problems warrant attention, Dr Batra said. Changes in walking patterns or deteriorating balance could sometimes indicate an underlying problem affecting the brain or spinal cord.
Certain conditions can cause pressure on the brain or spinal cord in the neck, resulting in subtle changes in walking patterns and the ability to maintain balance.
Dr Batra advised against dismissing increasingly abnormal changes in walking, particularly when they affect daily activities or occur alongside stiffness, tremors, weakness, numbness or difficulty with coordination.
Dr Atampreet Singh, Senior Director and Head, Institute of Neurosciences, ShardaCare - Healthcity, explained that disruptions in the systems responsible for maintaining balance can cause unsteadiness, difficulty walking in a straight line, frequent stumbling and an increased tendency to fall.
Recurrent balance problems may be associated with several neurological conditions, including:
In older adults, recurrent or unexplained falls may sometimes be an early indication of an underlying neurological or sensory deficit, Dr Singh told HealthandMe.
A sudden loss of balance, particularly when accompanied by other neurological symptoms, can be a warning sign of stroke and requires immediate medical attention.
Dr Singh highlighted the following symptoms to watch for:
Such symptoms require immediate medical assessment, the expert noted.
Seek medical attention if unsteadiness persists or worsens, particularly when accompanied by weakness or numbness in the arms or legs, frequent falls, severe headache, vomiting, changes in vision or speech, or loss of bladder or bowel control.
A doctor may conduct a neurological examination and recommend brain or spinal imaging, if necessary, to determine the cause.
The doctors noted that early diagnosis is important because some underlying conditions are treatable, and timely intervention may help prevent permanent neurological problems.
They advised patients to pay attention to when the imbalance began, whether it appeared suddenly or developed gradually, and whether it is accompanied by tremors, dizziness, numbness, weakness, speech changes or difficulty with coordination.
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When we talk about cancer prevention, the conversation usually turns to individual choices. Whether someone smokes, what they eat, how much they exercise, or how regularly they visit a doctor. These are important considerations, but they do not tell the whole story. A person's surroundings can influence their health in ways that are not always immediately apparent. The air they breathe every day, the conditions in which they work, the food they can afford and the healthcare available to them can all have a bearing on their risk of developing cancer.
In clinical practice, cancer rarely has one identifiable cause. It develops through a combination of factors, including age, genetics, infections, lifestyle and environmental exposure. Some of these can be modified. Others are tied to circumstances that people have little control over.
The air we breathe and the work we do
Air pollution is generally discussed in the context of respiratory and cardiovascular illness. Its association with cancer, particularly lung cancer, deserves equal attention. Fine particulate matter from vehicle exhaust, industrial emissions, construction dust and waste burning can remain in the air people breathe over long periods. Indoor air quality is another concern. In homes where wood, coal or other biomass fuels are used for cooking, poor ventilation can expose families to harmful smoke over many years.
The workplace presents a different set of risks. Construction workers, miners and employees in certain manufacturing industries may regularly come into contact with substances such as asbestos, silica dust and diesel exhaust. Prolonged exposure to these carcinogens is associated with specific cancers. The risk is not simply a matter of the nature of the job, but also the conditions under which it is performed. Protective equipment, adequate ventilation and routine workplace monitoring are therefore essential, not optional safety measures.
What ends up on the plate is not always a choice
Diet is another area where personal circumstances matter. What a person eats is influenced by affordability, availability, working hours and household responsibilities. A consistently poor dietary pattern, particularly one high in processed meat and low in fibre, is associated with an increased risk of certain cancers. Excess body weight is also linked to several cancers, including colorectal, endometrial and postmenopausal breast cancer.
This does not mean that eating a particular food will cause cancer, or that avoiding one ingredient will prevent it. The concern is with patterns that develop over time, alongside other risk factors. Advising people to eat better is only useful when that advice considers what they can realistically afford and access.
Why some communities face greater challenges
The same health advice does not translate into the same opportunities for everyone. People living in congested neighbourhoods may have limited control over their exposure to pollution. Workers in informal or unregulated sectors may not have access to adequate protective equipment or occupational health services.
These circumstances can also determine how quickly someone receives a diagnosis. A persistent cough, unexplained weight loss, a breast lump or unusual bleeding may initially be dismissed. For someone who has to travel long distances, lose a day's wages or pay out of pocket for investigations, seeking medical attention is not always straightforward. By the time they reach a specialist, the disease may have progressed.
Early detection, therefore, is not just about recognising symptoms. It also depends on whether people can access a doctor, undergo the necessary investigations and complete their follow-up care.
Prevention has to go beyond individual choices
There are established ways to reduce cancer risk. Avoiding tobacco, limiting alcohol, maintaining a healthy weight and staying physically active all matter. HPV and hepatitis B vaccination can help prevent cancers associated with these infections. Screening for breast, cervical and oral cancers should be undertaken as recommended, based on age and individual risk. A persistent or unusual symptom should always be evaluated rather than left unattended.
But prevention cannot stop at the doctor's consultation room. Cleaner air, safer workplaces, better housing and affordable diagnostic services need to be part of the larger conversation.
A person's risk of cancer is shaped by more than the choices they make. It is also influenced by the conditions in which they live, work and seek care. Recognising this is important because prevention becomes meaningful only when people have a fair opportunity to act on it.
(Dr Rajesh Shinde - Director – GI (HPB–Colorectal) & Thoracic Surgical Oncology, Apollo Cancer Centre, Western Region, Apollo Hospitals)
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