I think you need to either show that ketone use has potential harm, and if not you’d need to show that it violates the spirit of the sport. WADA’s formal requirements are that a substance has to meet two of three criteria:
- Performance enhancing in healthy athletes
- Actual or potential health risk
- Violates the spirit of the sport
How do you define “spirit of the sport”? It’s in the anti-doping code. And unfortunately, it’s vague and subjective.
Anti-doping programs seek to preserve what is intrinsically valuable about sport. This intrinsic value is often referred to as “the spirit of sport.” It is the essence of Olympism, the pursuit of human excellence through the dedicated perfection of each person’s natural talents. It is how we play true. The spirit of sport is the celebration of the human spirit, body and mind, and is reflected in values we find in and through sport, including:
• Ethics, fair play and honesty
• Excellence in performance
• Character and education
• Fun and joy
• Dedication and commitment
• Respect for rules and laws
• Respect for self and other Participants • Courage
• Community and solidarity
So, if there are articulable harms, then I think that while “spirit of the sport” is intrinsically vague, we can probably agree that it violates that. For example, overuse of systemic corticosteroids can cause adrenal gland insufficiency plus a bunch of lesser side but still unpleasant effects. (NB: the nasal spray you’d use for allergies doesn’t count here if used to treat normal allergies, although I guess you could huff it in industrial quantities and that would violate the spirit of the sport.) With ketones, I would guess that scientists would need to articulate how they could cause harm, or else show that empirically.
For things like EPO, we know that it’s performance enhancing in healthy athletes. You’re taking a hormone designed to treat very sick people. It’s a massive boost in performance. You’re taking something that’s normally produced by your endocrine system, and you’re pushing your production of red blood cells above what your endocrine system normally gives you.
Then the question is, how much disruption of normal body functions is acceptable. General nutrition is clearly OK. You’re eating food, your body metabolizes that normally.
I can see how ketone esters are in a grey area, but from what I know of the mechanism of action in athletes, I think they’re on the OK side right now. It’s basically a supplement to your muscle glycogen. The body should be able to burn ketones as fuel like glycogen, but they can be burned at a lower oxygen cost. It’s extra fuel. What puts it in the grey area is that it’s extra fuel, but it’s produced by a biological mechanism that isn’t active in a high-carb diet. The thing is, this isn’t like the things that work on your endocrine system. To the extent that it’s not what your body can normally do, we do accept many technological innovations in the sport. You can’t normally get into an aero position safely with drop bars, so we allowed time trial bars in time trials. Things like that.