With a home Olympics comes immense pressure to perform. Against that tapestry, during 2011 and 2012 UK Sport entered into arrangements with scientists at the University of Oxford including Australian Professor Kieran Clarke. At its crux, the purpose of the relationship was to undertake “research” into whether a substance branded as DeltaG (and commercially available since about 2018, branded “HVMN”) might improve the performances of elite athletes.

DeltaG is what’s known as a “ketone ester”. Anyone who’s followed the Atkins Diet or an intermittent fasting regime will know that ketosis is a metabolic state in which the human body basically burns fat for energy after a person is depleted of carbohydrates. Elite athletes don’t eschew carbs; the addition of a ketone ester such as DeltaG essentially tricks the body into a ketogenic state, igniting a simultaneous energy source. Where an athlete can deploy multiple energy sources at once, in theory at least, improved performance will be achieved.

In the months leading up to the London Olympics, over 40 percent of the experiment subjects endured side-effects including vomiting and other gastrointestinal issues.

The patent rights underpinning DeltaG are owned by a UK-based company, Tdeltas Limited (itself a spin-out of Oxford University). That company was registered in 2005. Clarke is a director and the company secretary; she owns greater than 25 percent of the company’s shares. One DeltaG patent, listing Clarke as one of the inventors, was filed in August 2013. Clarke is however listed in the worldwide patent database as the inventor, on at least half a dozen of Tdeltas’ patents relating to ketone products and inducing the ketogenic process.

To be clear, none of the foregoing is unusual. Whether or not DeltaG was, or wasn’t developed at the University of Oxford is immaterial. It’s irrelevant, whether or not it’s actually true, that DeltaG was invented on the back of millions in seed funding provided by the US Department of Defence, looking for a human fuel that Special Forces soldiers could ingest to be able to operate longer behind enemy lines without rations.

What is of manifest concern though, is that the UK’s peak government-sponsored sports agency might consider it prudent on balance, to involve elite athletes in any “research” process designed to determine the efficacy of the DeltaG substance.

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Before the English Institute of Sport was established, UK Sport worked directly with third party research and innovation partners, including Oxford University. It isn’t disputed that the DeltaG studies of 2011 and 2012 involved over 90 British elite athletes, drawn from over a half-dozen different sports. A 2012 patent application filed by Tdeltas explains studies carried out on elite British rowers. The 2013 patent specifies 10 male Team GB athletes, each of whom represented their nation in international competition in endurance events.

It also hasn’t been denied by UK Sport that it required participating athletes to execute a series of liability waivers and releases, absolving UK Sport from all liability and responsibility: if any athlete ended up committing an anti-doping rule violation in the run-up to the Games, through their participation in DeltaG experiments; if the World Anti-Doping Agency retrospectively declared to be illegal, what was considered to be within the bounds of doping rules; and/or if an athlete suffered injury, illness or worse.

In the months leading up to the London Olympics, over 40 percent of the experiment subjects endured side-effects including vomiting and other gastrointestinal issues. The vast majority withdrew from the experiment for these reasons. Another quarter pulled out because they had formed the view that DeltaG offered no performance benefit.

It’d be sensationalist to suggest Team GB’s 65 Olympic medals, and its ascent to third on the overall medal table in 2012, was fuelled by DeltaG. The opposite seems likely. But crucial questions must be asked about whether UK Sport has discharged its duty of care, owed to athletes it was spending millions in government money to develop.

If UK Sport was so convinced that athletes being administered DeltaG wouldn’t traverse anti-doping rules (in a letter dated 13 October 2011, UK Anti-Doping confirmed in writing to UK Sport the apparent opinion of WADA’s Science Department, that DeltaG didn’t SEEM to be of “particular concern from an anti-doping perspective“), why demand athletes promise “it’s all on them”, if the converse proves to be true?

This isn’t at all a hypothetical consideration. In 2011, WADA inserted a new class of prohibited substances on its banned list. “Class S0” substances, outlawed for use by athletes at all times, include “pharmacological substances … with no current approval by any governmental regulatory health authority for human therapeutic use“. That was intended to stop rogues like Stephen Dank using footballers as guinea pigs (and how did that work out?!?!?). DeltaG is marketed now as a food substance, yet my Concise Oxford English Dictionary defines “pharmacology” as the branch of medicine concerned with the use, effect and action of drugs. A “drug” is a substance which has a marked physiological effect when ingested.

So answer me this: if DeltaG actually has the physiological effect of tricking the body into a ketogenic state; and if in 2011 DeltaG was still very much in the “research” phase of development, without any governmental health approvals for use on people in any therapeutic sense – is DeltaG a food or a pharmacological substance? Of more concern, nobody actually knows what, if any, permanent damage could be caused to an elite athlete’s liver and other vital organs, through prolonged use of substances like DeltaG.

DeltaG’s party trick is to convince the liver to operate in a way it naturally shouldn’t. In 2020, ketone supplements are, for example, widely used among the pelotons of professional cycling. You can buy some DeltaG for yourself through Tdeltas Limited’s website. In a decade’s time, is it possible that a cohort of former elite cyclists might present with horribly pickled livers? The problem is, nobody knows. It could be that treating diagnosed medical conditions with DeltaG is fine, but the use by elite athletes with no physiological deficiencies, is the opposite.

Put simply, Article 4 of the World Anti-Doping Code mandates that a substance must be prohibited if medical or other scientific evidence, a pharmacological effect or experience demonstrates that (a) the substance does, or does have the potential to enhance sport performance; and (b) the use of the substance represents an actual or potential health risk to athletes.

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The conclusions stated in Tdeltas Limited’s own patent claims point to demonstrated “… improved endurance during and recovery after exercise …”. The deleterious health impacts of use, and also prolonged use of ketone substances are not entirely known; reports suggest that four in 10 Team GB athletes got real crook though. This situation demands abundant caution, and a deep and critical evaluation by WADA regarding whether such substances should be permitted for use by athletes on any basis.

In the past year, a number of European professional cycling teams, competing at the highest level, have called for the use of ketones to be banned, in the interests of riders’ health. Problem is, only WADA, and not cycling’s international governing body or any other authority, can make and enforce that decision.