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Because of health risks, France banned titanium dioxide as a food additive in 2020. Two years later the European Union also banned titanium dioxide as a food additive. 

In order to achieve the same solids content, the larger filler and the binder should be reduced if necessary.  

In a study published in the journal Environmental Toxicology and Pharmacology in 2020, researchers examined the effects of food additives titanium dioxide and silica on the intestinal tract by grouping and feeding mice three different food-grade particles — micro-TiO2, nano-TiO2, and nano-SiO2.  With all three groups, researchers observed changes in the gut microbiota, particularly mucus-associated bacteria. Furthermore, all three groups experienced inflammatory damage to the intestine, but the nano-TiO2 displayed the most pronounced changes. The researchers wrote: “Our results suggest that the toxic effects on the intestine were due to reduced intestinal mucus barrier function and an increase in metabolite lipopolysaccharides which activated the expression of inflammatory factors downstream. In mice exposed to nano-TiO2, the intestinal PKC/TLR4/NF-κB signaling pathway was activated. These findings will raise awareness of toxicities associated with the use of food-grade TiO2 and SiO2.”

Other research suggests that E171 could cause harm; however, those research processes did not consider how people are typically exposed to E171. Research that adds E171 to drinking water, utilizes direct injections, or gives research animals E171 through a feeding apparatus is not replicating typical human exposure.