A group of physicians, researchers and public health experts has urged Food and Drug Administration (FDA) Commissioner Margaret Hamburg to consider the purported adverse health effects, particularly for children and adolescents, posed by energy drinks containing high levels of caffeine, apply existing generally recognized as safe standards to such beverages and require manufacturers to provide caffeine content on product labels.

In their March 19, 2013, letter, the signatories cite their own and others’ research to claim that an increase in the consumption of products with added caffeine has been associated with fatalities and injuries, increased emergency room visits, cardiovascular complications, seizures, childhood obesity, and risky behaviors when combined with alcohol. They contend that while caffeine’s effects on adults are known, safe levels for teenagers have not been sufficiently shown.

In a related development, several energy drink companies, including Monster Beverage, have reportedly changed their product labels to declare the caffeine content and decided to cease marketing the products as dietary supplements, evidently to avoid obligations to report adverse events to federal regulators. Monster Beverage and Rockstar Energy drinks will now apparently be marketed as beverages. Monster Energy has also reportedly become a member of the American Beverage Association.

The initiatives come in the wake of a wrongful death lawsuit against Monster Beverage and as critics increase their calls for action over safety concerns. The company recently held a press conference to challenge evidence submitted in the lawsuit and, according to a news source, has threatened to sue the publisher of a newsletter for elementary schools over statements the company says are defamatory.

According to Deborah Kennedy, the nutritionist who writes the newsletter and called for children from kindergarten through fifth grade not to consume the beverages, the company demanded that she retract and correct the statements or face litigation. A Monster Energy spokesperson reportedly said that the child of a company employee read the newsletter and was upset by it. He said, “No child, much less a 7-year-old, should be falsely informed that his or her father’s employer is a child killer, especially since there are no facts to support the allegation.” See The New York Times, March 19 and 21, 2013.