The coroner’s report said the tragic event was most likely triggered by Squires consumption of a DMAA (1,3-dimethylamylamine/methylhexaneamine) supplement during the 42.2 kilometre race.
"She had taken a supplement containing DMAA, which on a balance of probability, in combination [with] extreme exertion, caused cardiac failure, which resulted in her death,” said coroner Dr Philip Barlow.
DMAA-containing products such as Jack3D (USPlabs) which Squires took were banned in the UK a few months later by the UK Medicines and Healthcare products Regulatory Agency (MHRA), joining nations throughout Europe and the rest of the world in condemning the substance over safety and sourcing concerns (was it found in geranium or not?).
It has been linked to other deaths and health problems, but usually when the stimulant has been used in a recreational sense, as a party aid. Squires is said to have taken just one scoop of DMAA – a recommended dose.
The 30-year-old London resident had purchased Jack3D online and had told acquaintances she intended to use it if she felt like she was dropping in energy levels toward the end of the race (in marathon parlance: ‘hitting the wall’). Her boyfriend said she had also used it in training, again following recommended dosage.
According to The Guardian newspaper Squires told her boyfriend: “If I hit a bit of a wall, I might take this drink and see if it pushes me through the end of the marathon.”
While the product is banned in many countries it remains available on the internet and in outlets in markets where no ban has been imposed.
Energy supplement rethink
Speaking with NutraIngredients, London marathon chief executive, Nick Bitel said UK running authorities were working on updating energy supplement advice that will be added to standard nutrition and hydration advice given to racers before sanctioned events in Britain.
“Perhaps this tragic death highlights the need for tighter regulation of the supplements industry,” he said. “The fact is that this kind of supplement should never have been on sale.”
“We shouldn’t have dead bodies…”
Large sections of the food and sports supplements industry including the Council for Responsible Nutrition UK (CRN-UK) have however raised red flags about the substance and long-called for its demise.
The US Anti-Doping Agency’s (USADA) chief executive, Travis Tygart, warned of its growing use in a video interview with us before the regulatory hammer came down on the pre-workout supplement in 2012.
“It’s causing a lot of positive drug tests,” Tygart said after DMAA was logged on the World Anti-Doping Agency (WADA) prohibited substance list.
“But more importantly it’s a potent stimulant and we shouldn’t have dead bodies before retailers and suppliers and contract manufacturers say, you know what, here is a substance... that we might be making a lot of money off of it, and they certainly are, but it is illegal.”
In the wake of the London Olympics, the MHRA noted DMAA had caused more doping offences (137) for elite athletes in the past two years than another other substance on the World Anti-Doping Agency’s (WADA) prohibited list of more than 240 substances (to August 2012).
DMAA consumption has been linked to cardiac disorders, nervous system disorders and psychiatric problems.