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Relatively tricky, and have a tendency to eject out if it’s a bumpy road… but if the general data they tend to be faster than them not being there and if you need to carry specific nutrition then there aren’t many other options…
That said if it’s just for water most long distance races have aid stations every 20k or so, and a between the arms is both easier to drink from and better aerodynamically!
Anyone fancy weighing in on bottle options for distance races? Was thinking of a double saddle holder but have no idea how awkward they are to use