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In a 2019 study published in the journal Nanotoxicology, researchers recreated the first phase of digestion in mice and fed them titanium dioxide, then examined whether accumulation occurred in the organs. Researchers wrote: “Significant accumulation of titanium was observed in the liver and intestine of E171-fed mice; in the latter a threefold increase in the number of TiO2 particles was also measured. Titanium accumulation in the liver was associated with necroinflammatory foci containing tissue monocytes/macrophages. Three days after the last dose, increased superoxide production and inflammation were observed in the stomach and intestine. Overall, [this] indicates that the risk for human health associated with dietary exposure to E171 needs to be carefully considered.”

Thanks to its rheological and optical properties, Lithopone offers both technical and economic advantages wherever organic and inorganic binder systems require a relatively high pigmentation for specific applications.

Of the products that include the additive in their labels, Thea Bourianne, senior manager at data consultant Label Insights, told Food Navigator USA in May 2021 that more than 11,000 products in the company's database of U.S. food and beverage products listed titanium dioxide as an ingredient. Non-chocolate candy led those numbers at 32%. Cupcakes and snack cakes made up 14%, followed by cookies at 8%, coated pretzels and trail mix at 7%, baking decorations at 6%, gum and mints at 4% and ice cream at 2%.

Relative to a lot of other things that people should be concerned about, titanium dioxide in my mind, is really low on the list. I would be more worried about some substitutes that people are using for titanium dioxide that don't have decades of research associated with it, said Westerhoff.

Titanium dioxide has many purposes in both food and product development.