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.

You can feel fine and still have a heart that is slowly changing. Researchers at Imperial College London and the MRC Laboratory of Medical Sciences say millions of people could be living with hidden inflammation that does exactly that. They say the changes can start years before any symptoms show up.

"Our study, which is the largest of its kind, suggests that millions of people could be living with hidden inflammation, which is slowly changing their heart and causing long-term damage," said Professor Declan O'Regan, British Heart Foundation Chair of Cardiovascular AI at Imperial College London.

What The Study Found

The study was published in the European Journal of Preventive Cardiology. The team looked at data from nearly 480,000 adults in the UK Biobank, a large health database, Imperial says. They measured a blood marker called glycoprotein acetyls, or GlycA for short, which the paper uses to measure chronic inflammation. They also used heart scans and genetic data.

People with the highest levels of inflammation, the top 20%, had a 43% higher risk of heart attack and stroke than those with the lowest levels, the bottom 20%, according to Imperial.

Imperial adds that higher levels also went with changes in the heart itself. These included thicker heart walls, smaller heart chambers and poorer filling of the heart. The researchers say such changes can build quietly for years before possibly leading to heart failure.

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Where The Inflammation Comes From

Chronic inflammation is a long-term, low-level activation of the immune system, Imperial explains. It has been linked to cancer and diabetes, and is increasingly seen as a driver of heart disease.

According to Imperial, higher inflammation was strongly linked to poorer social and economic circumstances and to mental distress, as well as to smoking and excess body fat.

"The surprising thing was how much social factors and mental health are linked to inflammation and damage to the heart, as well as more well-known risk factors like smoking and inactivity," O'Regan said. He added that there was also a strong genetic factor, "with some people being naturally more resilient or susceptible to the inflammatory damage that comes from different lifestyles."

What Could Come Next

The study named proteins from the interleukin-1 and TNF families as likely drivers of the damage, Imperial says. Several are already targeted by drugs in clinical trials, which Imperial says raises hopes that anti-inflammatory treatments could help prevent heart disease before symptoms begin. The researchers say combining inflammation blood tests with genetic risk scores could help find the people who would benefit most from early action.

There is earlier proof that this idea can work. In the 2017 Canakinumab Anti-inflammatory Thrombosis Outcomes Study, or CANTOS trial for short, led by Paul Ridker and published in the New England Journal of Medicine, 10,061 people who had already had a heart attack, and had high inflammation, were given canakinumab or a placebo. The paper concluded that at the 150 mg dose, given every three months, canakinumab led to fewer repeat cardiovascular events than the placebo, independent of any drop in cholesterol. But those were heart attack survivors, not people without symptoms.

What to keep in mind

The study reports links, and the researchers describe inflammation as one possible pathway to heart damage. They also stress that being genetically susceptible, or living in hard circumstances, does not mean a person will develop heart disease, and that much can be done to prevent long-term inflammation.

A few floaters, a brief flash of light or mild blurring across your vision may seem harmless at first. But when these changes appear suddenly without any probable cause, they may signal a bigger problem. On World Retina Day, experts explain when your retina needs urgent medical attention.

The retina is the light-sensitive layer at the back of the eye, which plays a crucial role in maintaining healthy eyesight. Some retinal conditions may develop without obvious symptoms in early stages, while others can present suddenly and threaten your eyesight if treatment is delayed.

“Retinal health is fundamental to maintaining clear vision and preserving quality of life, yet many retinal conditions can develop silently, without obvious warning signs in their early stages,” Dr Rajesh Kapoor, Medical Director, Suruchi Eye Hospital, Navi Mumbai told HealthandMe.

“By the time a person begins to notice blurred or distorted vision, dark spots, flashes, floaters, or other visual changes, the condition may already require urgent medical attention. This is why we need to shift our approach from waiting for symptoms to prioritizing awareness, regular comprehensive eye examinations and timely consultation with an ophthalmologist.”

What Are Floaters And Flashes?

Floaters can look like tiny dots, lines, specks or cobweb-like shapes moving across your field of vision. They are easier to notice when looking at a bright background.

Flashes, on the other hand, can look like brief streaks or bursts of light. They may occur even when there is no actual source of light around you.

Occasional floaters can occur for reasons that are not always serious. However, a sudden increase in floaters or the sudden appearance of flashes should not be dismissed, especially if there are other changes in vision. One of the conditions doctors want to rule out in such situations is retinal detachment.

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What Is Retinal Detachment?

“Retinal detachment is a serious condition which requires urgent medical attention and occurs when the retina, the light sensitive layer at the back of the eye pulls away from its normal position,” Dr Mudit Tyagi, Scientific Chair, VRSI and Head, Smt Kanuri Santhamma Center for VitreoRetinal Diseases, L V Prasad Eye Institute, Hyderabad told HealthandMe.

There are several possible causes of retinal detachment. According to Dr. Tyagi, they include injury to the eye, high myopia and certain eye diseases.

When the retina separates from its normal position, its ability to function properly can be affected. The longer the condition remains untreated, the greater the concern about permanent vision loss.

Sudden Flashes And A Curtain Or Shadow Over Your Vision

The symptoms of retinal detachment can vary, but certain changes should warrant immediate medical attention.

A dark curtain or shadow across the field of vision is concerning because it can represent a portion of the visual field being lost.

Dr. Tyagi said, “The urgency of recognising retinal detachment can’t be overstated. If you have sudden flashes of light, a dramatic increase in floaters, or a dark shadow or curtain across your field of vision, don’t ignore it, even if there is no pain.”

The absence of pain should not be misconstrued as a non-emergency. A retinal problem can occur without the kind of discomfort people usually associate with an eye emergency.

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Timing Is Key

Retinal detachment is not a condition where it is advisable to wait and see whether symptoms settle on their own. “Retinal detachments, if detected in time and operated early enough can result in a good recovery of vision,” Dr Tyagi said.

He added, “It is important, therefore, to be vigilant and see an eye care specialist as early treatment can help avoid preventable loss of vision. So, timely recognition and diagnosis followed by right treatment can help save vision.”

This is why sudden visual changes deserve attention even if they seem minor initially.

Who Is At Risk?

Some people may need to be particularly proactive about retinal health. Dr. Kapoor said individuals with diabetes, increasing age, a family history of retinal disease or other risk factors that may affect retinal health should be more careful and alert.

Diabetes can affect the blood vessels supplying the retina and lead to diabetic retinal disease. Regular eye examinations can help identify changes before vision is significantly affected. Dr Kapoor also stressed that screening should not necessarily wait until symptoms appear.

“Advances in retinal imaging, diagnostics and treatment today provide ophthalmologists with valuable opportunities to identify and manage several retinal conditions at an earlier stage. However, technology can make its greatest impact when people seek eye care at the right time.”

A sudden change in vision does not automatically mean that a person has retinal detachment. But because some retinal conditions can progress rapidly, it is important to have sudden symptoms assessed rather than trying to determine their cause on your own.

Dr Kapoor said: “Through greater public awareness and proactive screening, we can encourage people to take retinal health more seriously. Protecting sight begins with understanding that healthy vision should never be taken for granted—because when it comes to the retina, we should not wait for a problem to become noticeable before taking action.”

After surgery, radiotherapy could significantly decrease the chances of an atypical meningioma returning, according to a new international phase 3 trial published in The Lancet.

The findings come from the ROAM/EORTC-1308 trial, the first randomised controlled trial to directly test whether patients with a completely removed atypical meningioma benefit from receiving radiotherapy or whether regular scans and observation are enough.

The results could help settle a treatment question that has remained uncertain for years.

What Is An Atypical Meningioma?

Meningiomas are the most common brain tumours in adults. They develop from the meninges, the protective membranes surrounding the brain, and spinal cord.

An atypical meningioma is classified as a WHO grade 2 tumour. Unlike grade 1 meningiomas, that generally grow slowly, grade 2 tumours are more likely to grow again after surgery.

Even when surgeons manage to remove the entire visible tumour, microscopic tumour cells may remain, sparking a risk of recurrence.

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What Did The Lancet Study Find?

The ROAM/EORTC-1308 trial enrolled 157 patients whose atypical meningiomas had been completely removed surgically. They were randomly assigned to either:

• Radiotherapy: 78 patients received 30 sessions of radiotherapy
• Observation: 79 patients underwent regular imaging surveillance

After a median follow-up of about five years, the difference in recurrence was significant. 14% of patients in the radiotherapy group experienced a recurrence, compared to 30% in the observation group. In other words, the risk of recurrence was reduced by nearly half with postoperative radiotherapy.

Additionally, at five years, about 80% of patients receiving radiotherapy remained free of recurrence, compared to about 64% of those who were monitored without immediate radiotherapy.

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The Trial Cements Necessary Evidence

Until now, doctors have had to weigh two approaches after complete surgical removal of an atypical meningioma.

One option is to give radiotherapy immediately, hoping to destroy microscopic tumour cells that surgery may have missed. The other is to monitor the patient with regular brain scans and use radiotherapy if the tumour returns.

The uncertainty existed as strong randomised evidence showing whether immediate radiotherapy actually reduced recurrence had been lacking. The trial helps cement that evidence.

Who Needs Radiotherapy After Surgery?

The researchers say that treatment decisions still need to be made jointly by doctors and patients, taking into account possible side effects and the long-term consequences of radiation treatment. Serious radiation-related complications were uncommon in the trial.

The study also did not establish whether the recurrence benefit extends beyond five years. This means that longer follow-up will be needed to gather more evidence. According to the researchers, the findings are expected to shape national and international treatment guidelines.

The options may extend for patients who have undergone complete removal of a WHO grade 2 atypical meningioma. Rather than contemplating “Should we simply watch and wait?”, they can consider moving to a more evidence-based discussion about whether postoperative radiotherapy should be offered upfront.