I have used a pair of Lake size 45 for the past year. I have a good size bunion on one foot which actually wore a hole in a previous pair of shimano shoes. The Lakes are a little snug particularly on that foot when I wear them with socks but otherwise have been a large improvement over all the traditionally available bike shoes. And I have tried all of them at one time or another. I run in Altra's and would say that for me the fit is similar.

Steve