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March 12, 1982

Straining Out Gnats

JAMA. 1982;247(10):1407. doi:10.1001/jama.1982.03320350021013

To the Editor.—  A medical journal has, on two occasions,1,2 recently devoted considerable space to warnings and discussions of the minuscule amounts of sugar in antacids. Calculating the actual number of calories involved shows that the "risk" to diabetics ranged up to 9.6 calories per dose or an average added caloric intake of 38.4 calories per day— calorically equal to one-half slice of bread. Whether the proved benefits of antacids for ulcers should be withheld for risk of adding 38.4 calories to the daily diet seems highly questionable.As a clinician I believe that today we may "Strain out a gnat while swallowing a camel" (Matthew 23:24).At a time when the American Heart Association states that there are 100,000 fewer deaths per year from heart disease and stroke, at a time when the American Cancer Society states that the cancer death rate for persons younger than 50 years