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In June 2022, Health Canada weighed in on the debate, releasing a report on the safety of titanium dioxide. Their expert panel reviewed toxicity studies, including ones involving genetic damage. The expert panel found that previous studies used different forms and properties of titanium dioxide and deliberately broke the material into smaller particles than what you would normally see in food.

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Wegman’s puts titanium dioxide in its Original Macaroni and Cheese. Campbell’s Healthy Request Chunky Chicken Corn Chowder has it, as does Food Club’s Chunky New England Clam Chowder. Marzetti uses the color agent to brighten its Cream Cheese Fruit Dip. Dairy products usually don’t need titanium dioxide to look white, but Kroger has decided to add titanium dioxide to its Fat Free Half-and-Half. And titanium dioxide isn’t only in especially white or brightly colored foods: Little Debbie adds it to Fudge Rounds and many other products. According to the Food Scores database maintained by Environmental Working Group, more than 1,800 brand-name food products have titanium dioxide on their ingredients list. That said, it can still lurk as an unspecified “artificial color,” or labels might simply say “color added.”

In vitro, in the hemocytes of the marine mussel Mytilus hemocytes, suspension of TiO₂ NPs (Degussa P25, 10 μg/ml) stimulated immune and inflammatory responses, such as lysozyme release, oxidative burst and nitric oxide production. Vevers and Jha demonstrated the intrinsic genotoxic and cytotoxic potential of TiO₂ NPs on a fish-cell line derived from rainbow-trout gonadal tissue (RTG-2 cells) after 24 h of exposure to 50 μg/ml. Reeves et al. demonstrated a significant increase in the level of oxidative DNA damage in goldfish cells, and suggested that damage could not repaired by DNA repair mechanisms. Another suggestion from the mentioned study was that hydroxyl radicals are generated also in the absence of UV light. It has been shown that fish cells are generally more susceptible to toxic/oxidative injury than mammalian cells.