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After oral ingestion, the absorption of titanium dioxide particles is low, however they can accumulate in the body, Maged Younes, chair of the European Food Safety Authority's expert Panel on Food Additives and Flavourings, said in a May 2021 statement.

With the rise of nanotechnology, research in recent years has also shown the dangers of titanium dioxide (TiO2) nanoparticles, and their genotoxicity, which refers to a chemical agent’s ability to harm or damage DNA in cells, thus potentially causing cancer. 

Although cosmetics are not meant for consumption, there are concerns that titanium dioxide in lipstick and toothpaste may be swallowed or absorbed through the skin.

It’s also used in food products to provide a white color. Candies, cakes and creamers are examples of foods that may contain titanium dioxide for its color enhancing and bleaching properties.

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From a stability standpoint, lithopone, a fusion of zinc sulfide and artificially precipitated barite, is non-toxic and exhibits resilience to mild lyes and acids. However, it is incompatible with colors containing copper. Despite its strong covering power in oil, lithopone’s drying capabilities are notably limited, posing potential issues for artists. Notably, early experimentation with lithopone-based grounds instead of zinc white resulted in undesirable darkening, although this blackness receded upon drying. This unpredictable behavior has sparked debate among scientific communities, emphasizing the need for further exploration and understanding of this pigment.

For a review published in 2023 in the journal Environmental Pollution, researchers examined E171 as a possible factor promoting obesity-related metabolic disorders. Because gut microbiota play an important role in immune function maintenance and development, and because titanium dioxide as a food additive has been shown to alter gut microbiota, researchers wanted to review “the dysregulations along the gut microbiota-immune system axis after oral TiO2 exposure compared to those reported in obese or diabetic patients, and to highlight potential mechanisms by which foodborne TiO2 nanoparticles may increase the susceptibility to develop obesity-related metabolic disorders.” The study authors discovered recurrent changes in the gut microbiota composition when exposed to titanium dioxide nanoparticles, with an imbalance of intestinal symbiotic microbiota. These changes and imbalances were also reported and played a role in the development of obesity, the authors wrote. This highlights “foodborne TiO2 nanoparticles as an endocrine disruptor-like chemical promoting obesity-related disorders,” the authors concluded.

Other food manufacturers use titanium dioxide to absorb water and keep moisture from clumping or degrading, Paul Westerhoff, PhD, an environmental engineer at Arizona State University who researches the biological and cellular effects of titanium dioxide, told Health.

This cytotoxic effect was also reported before; i.e. Natarajan et al. conducted an experiment that found a strong oxidative stress, morphological changes in mitochondria and substantial loss in the fusion of primary hepatocytes exposed to P25TiO₂NPs [52].