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Amount: if too little titanium dioxide is added, the distance between particles is too large and there is not enough opacity, while if the titanium content is too high, the particles interfere with each other and poor efficiency is obtained.

In a study published in the journal Food and Chemical Toxicology in 2016, researchers investigated whether titanium dioxide exposure led to an increase in colorectal tumor creation in mice by using a colitis associated cancer model. By measuring tumor progression markers, the researchers found that mice given titanium dioxide experienced enhanced tumor formation in the distal colon.  There was also a decrease of cells that act as a protective barrier in the colon. The researchers wrote: “These results suggest that E171 could worsen pre-existent intestinal diseases.”

Faber argued there hasn't been enough change in these federal regulations in the decades following the FDA's approval of titanium dioxide – especially as others increasingly point to potential health consequences.