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In a 2022 study published in the Journal of Hazardous Materials, scientists wanted to examine the effects of titanium dioxide as a food additive on atherosclerosis in mice. (Atherosclerosis refers to a hardening of the arteries.) Researchers fed mice 40 mg/kg of the food additive every day for 4 months, and found that it not only altered gut microbiota but also led to a significantly increased atherosclerotic lesion area, especially in animals that consumed a high-choline western diet (HCD).

Lithopone has therefore traditionally been used in stoppers and putties, jointing compounds and sealing compounds, primers and undercoats and in road-marking paints.

A few non-dietary studies have reported adverse effects in the gastrointestinal tract of laboratory animals given food-grade TiO₂. However, these same effects were not seen when the same or higher doses of food-grade TiO₂ were administered in the animals' diet. Dietary studies best reflect how humans are exposed to TiO₂ from food. Thus, the Food Directorate placed the most emphasis on the results of these studies in the state of the science report.