Bottling athletic excellence

University of Cape Town (UCT) PhD candidate Shaun Sutehall is working with elite athletes to develop Swiss company Maurten’s new “hydrogel” drink, which has the potential to enhance sporting performance.

Already Sutehall, who is currently based at the University of Stirling in the United Kingdom, has seen success among elite marathon runners in East Africa who have taken the drink during big races – and he has high hopes that these results can be expanded to other athletes.

The drink was initially tested on elite athletes training in Ethiopia, where it was found to be very well tolerated at carbohydrate concentrations much higher than would normally be possible to ingest while running. It was subsequently used in competition in the Berlin Marathon in 2016 by Ethiopian athlete Kenenisa Bekele, who narrowly missed the (then) world record.

Bekele holds the world record and the Olympic record in both the 5 000 m and 10 000 m events and is widely acknowledged as the greatest runner of all time. In winning the 2016 Berlin event in a time of 2:03:03, he set a new personal best for himself in a marathon and clocked the second-fastest marathon time in the world.

Sutehall, who is studying for his MSc/PhD under the co-supervision of UCT’s Professor Andrew Bosch and Professor Yannis Pitsiladis of the University of Brighton in the UK, has been investigating the gastric emptying characteristics of the drink, as well as the rate at which the carbohydrate is used by the muscles, or the “oxidation rate”.

He recently presented his initial findings at the 35th International Federation of Sports Medicine (FIMS) World Congress of Sports Medicine held in Rio de Janeiro.

He also works with the Sub2hrs Project which is dedicated, through science, to promoting the achievement of a sub-two-hour marathon within five years.

Unique drink

“I believe this drink is a big success with the elite marathoners as many of them suffer from stomach problems while running. This drink now allows them to consume carbohydrate without these negative feelings,” Sutehall explained.

The drink is unique in that it contains sodium alginate which, when in contact with a low pH, forms an encapsulation around the carbohydrate in the drink. This “hydrogel” then flows into the intestine, bypassing the receptors which normally detect carbohydrate. This means that because the receptors fail to detect the carbohydrate, they do not slow down the emptying of the stomach.

This then also prevents the feeling of nausea and stomach upset often associated with drinking a high concentration of carbohydrate. 

“I am currently performing two studies in Scotland with Associate Professor Stuart Galloway at the University of Stirling. The first of these studies involves participants swallowing a nasogastric tube which sits in their stomach while we pass 500 mL of the Maurten carbohydrate drink directly into their stomach,” he explained.

“Over 90 minutes we are collecting stomach contents and blood samples, then comparing how quickly the Maurten drink empties in comparison with a ‘normal’ carbohydrate drink.”

“Over 90 minutes we are collecting stomach contents and blood samples, then comparing how quickly the Maurten drink empties in comparison with a ‘normal’ carbohydrate drink containing the same amount of carbohydrate.”

Sutehall’s second study involves participants running at 70% of their maximum effort for 105 minutes while ingesting Maurten or “normal” carbohydrate drinks.

“During this time, we collect blood and breath samples which allow us to determine the amount of carbohydrate in the drink that has been used within the muscle during the run.” 

Sutehall said it is hoped that the results of the gastric emptying study will be published before the end of the year, and those of the running study near the start of 2019.

“We are already beginning to plan studies to be carried out in 2019, possibly based on the application of our new findings during a real marathon.”

Sutehall said he finds great satisfaction “working at the forefront of research and pushing the limits of human knowledge”.

“Working on research questions which no-one knows the answer to and seeing the data answer these questions is the best job in the world. Then, working with the Sub2hrs Project I am required and expected to implement this newly discovered information into the training/racing of elite marathoners and therefore must be able to communicate simply on the research.

“The mix of academic research and applied work with elite athletes is a great experience and not very common nowadays, so I’m further motivated to stay at the top of both of these fields.” 

Carbohydrate metabolism

 Sutehall studied sport science at the University of Brighton, graduating in 2016 with a BSc(Hons) degree.

“During my final year at Brighton, I met Professor Pitsiladis who became my supervisor on my dissertation titled ‘A Novel Approach to the Detection of Recombinant Human Erythropoietin’, which aimed to identify a genetic signature of EPO in saliva,” he said.

“Following the completion of this work I joined the Sub2hrs Project, led by Professor Pitsiladis. With my experience in anti-doping research and interest in carbohydrate metabolism, this led me to join UCT with the head of Sub2hrs nutrition Professor Bosch.”

Sutehall’s interest in sports performance grew out of his long-held interest in sport.

“My passion for elite sports performance was found in Ethiopia. Soon after the completion of my degree, I went to Ethiopia to assess whether the Maurten drink should be used with Kenenisa Bekele in his next marathon. Kenenisa used the drink in the Berlin Marathon 2016 when he ran a 2:03:03.

“During this experience I saw first-hand the training and environment that has created so many of the world’s elite runners. There is very little (if any) science that is used in the training, so the work and research I am doing in East Africa feels that much more important and rewarding.”

Of his inspiration for his PhD research, Sutehall explained that carbohydrate is an essential fuel for elite endurance performance.

“While exercise can be fuelled using fat as [an energy] source, it requires significantly more oxygen to run at the same speed compared with burning carbohydrate. Therefore, for an athlete running at 21 km/h for two hours, carbohydrate supplementation is a must.

“The downside, however, is that high amounts of carbohydrate often cause stomach upset, vomiting, diarrhoea and other negative symptoms. This is because receptors in the intestine detect large amounts of carbohydrate and this slows the emptying of the stomach which also leads to a bloated feeling.”

The new carbohydrate beverage, he said, interests him greatly because it could potentially prevent this, allowing athletes to run unhindered by stomach upsets, despite ingesting large amounts of carbohydrate.

“The Maurten drink emptied half the volume in around 17 minutes, whereas the ‘normal’ drink took around 44 minutes to empty half the volume.”

Although his findings to date are only preliminary, the gastric emptying study has revealed that the Maurten carbohydrate drink empties significantly faster than the “normal” drink.

“This suggests that the theory we are developing is correct. Specifically, the Maurten drink emptied half the volume in around 17 minutes, whereas the ‘normal’ drink took around 44 minutes to empty half the volume – a huge difference,” Sutehall explained.

While the data from running studies is not yet available, he added that there is some evidence of Maurten’s efficacy in the elite marathon field thanks to its use by many of the World Marathon Majors’ athletes since its 2016 launch.

More recently, Maurten was also used by Kenyan long-distance runner Eluid Kipchoge when he smashed the world marathon record, lowering it to 2:01:39.

Now, Sutehall said, it is imperative to assess the drink’s effect on performance.

“This then allows us in the Sub2hrs Project to make an evidenced-based decision on providing the carbohydrate drink during a marathon.”