Ketone esters thrown into spotlight amid cycling controversies

29 Sep 2020 --- The ketone esters market has received its annual publicity boost as a performance and recovery aid for pro cyclists competing in the world’s toughest and most famous bike race – the just-completed and COVID-19-rescheduled three-week-long Tour de France.

The strongest team in the race, Netherlands-based Jumbo-Visma, was the only team to go on the record about using ketone esters.

Its Slovenian leader and second-place finisher Primož Roglič stated somewhat ambiguously in a mid-race press conference: “Yeah, we are still using it. For the real effects, it’s really hard to say. It’s hard to feel it.”

Teams are obviously not going to shout about it if ketone esters are indeed producing significant performance gains. 

However, ketone ester suppliers spoken to by NutritionInsight reckon more than half the 22 team Tour de France peloton uses them for training, in-race “glycogen sparing” gains and post-race recovery, and have been for several years. 

Other teams like Deceuninck-QuickStep and Lotto-Soudal from Belgium have previously said they have used them.

Frank Llosa, the owner of leading US ketone esters manufacturer KetoneAid and supplier to many pro cycling teams, tells NutritionInsight: “Nobody wants to talk about it. I’m surprised Jumbo talked about it. Perhaps they find it safer to admit to it now instead of being accused of it later.”

Why so coy? Aren’t ketone esters – typically derived from a source like corn – legal? Yes and no…

Ketone data, distribution and doping
While some may prefer to keep ketones on the quiet in the interests of competitive advantage, the fact is ketone esters have a supply problem in that they are only officially approved for sale in the US.

The EU is yet to approve ketone ester as a Novel Food in its 27 member states despite an application made several years ago by UK supplier TDeltaS. An initial response to that dossier called for more data.

“The EU is really difficult – it’s just about impossible, and that’s been amplified by Brexit and COVID-19,” says TDeltaS’ CEO Kieran Clarke, professor of physiological biochemistry in the Department of Physiology, Anatomy and Genetics at Oxford University.

That means there is a procurement issue with third parties often required to bring ketones from the US into the hands of interested European or other international parties.

“I can only count about six teams that disclose to me who they are, but we have sold bulk orders to groups in the US that forward it, and some bulk orders go overseas without first contacting me, so I have no idea if they are part of a team, or what team,” Llosa says.Cycling’s international governing body has said it is monitoring the use of ketones but, as yet, has taken no action.

Further data required
Others agree with the EU that further data is required, even if ketones are not banned by the World Anti-Doping Agency (WADA). Cycling’s international governing body, the UCI, has said it is monitoring the use of ketones but, as yet, has taken no action.

The Movement for Credible Cycling (MPCC) is a France-based association that counts about half the pro peloton as members and imposes strictures on its members that often exceed the UCI’s or WADA’s. It advises its members against ketones, “given the side effects and uncertainty of long-term effects.” 

Dutch anti-doping authorities stated they were not comfortable with Jumbo-Visma’s ketone use, calling it a “grey area,” while Jumbo-Visma nutritionist Asker Keukendrup admitting ketone esters research was a work-in-progress.

“We do not expect that there will be any adverse health effects in the long term,” he says.

“Because so little research is available, we test them ourselves. As we mainly use them in competitions, all kinds of variables also play a role. That is why I think it will be years before we know enough about how it works.”

The doping links are probably not helped when it emerges, as it did this summer, that British sporting authorities were testing ketone esters on almost 100 athletes across eight sports way back in 2011 and 2012. 

This was in a bid to find performance gains ahead of the 2012 London Olympiad, well before ketone esters were legally available anywhere in the world. Participating athletes had to agree to keep the trial a secret and accept any doping or health risks that may have stemmed from it. 

Varied findings
As with much nutrition science, exogenous ketone esters use has shown varied results very much depending on the scale and type of expected gains, type of athlete and sporting discipline, other nutritional inputs and other variables. 

As it stands, some animal and human research indicate exogenous ketone supplementation can promote efficient fat burning in stressed situations, while preserving glycogen stores, reducing lactate levels and thereby yielding potential performance and recovery gains. 

Ketone esters are normally made by the liver as a back-up energy source when glycogen stores run low.

Research indicates a 65 ml bottle containing 25 g of ketone esters can elevate bodily ketone levels for 4-6 hours if consumed with a carbohydrate source.

Emerging data points to brain health, sleep, pain relief and immunity benefits.Emerging data on ketone esters point to brain, sleep, pain relief and immunity benefits.

US market shifts
Against this backdrop, the US market continues to evolve rapidly, with ketone esters often linked to nootropic benefits and marketed toward e-gamers and workers seeking cognitive performance gains.

The former biggest player, California-based HVMN, has temporarily left the space as it severed ties with TDeltaS earlier this year. 

Executive Chairman Geoffrey Woo tells NutritionInsight HVMN was exploring other supply avenues and had pivoted to nootropic offerings based around medium-chain triglycerides (MCT), botanical extracts and vitamins and minerals in the meantime.

With its supply deal with HVMN terminated and fed up with the lack of progress on EU approval, TDeltaS has launched a DTC brand – DeltaG – that will debut in the US in October, says Professor Clarke.

DeltaG, like KetoneAid and HVMN (previously), offers 65 ml bottles containing 25-30 g of ketone esters for around US$30 a bottle.

The high price, along with a rather bitter taste, is beyond what many people expect from a health drink. Addressing this, KetoneAid offers versions with reduced ketone concentration (5 g), the addition of ketone salts, a monkfruit-sweetened milder taste and lower cost. 

Professor Clarke says DeltaG will also offer a lower-dose version when it makes its US debut, in its case, 10 g of ketone esters per 59 ml bottle.

Llosa adds KetoneAid sales were up 429 percent year-on-year on Amazon where 50 percent of its sales occurred, but wouldn’t disclose revenue figures. 

The firm was considering establishing a procurement center in Europe, despite the Novel Foods situation.

By Shane Starling