The evidence also suggests that the toxicity of TiO₂ particles may be reduced when eaten as part of the diet. This is because proteins and other molecules in a person's diet can bind to the TiO₂ particles. This binding alters the physical and chemical properties of the particles, which influences how they interact with cells, tissues and organs.

The other form in which titanium dioxide is produced is as an ultrafine (nanomaterial) product. This form is selected when different properties, such as transparency and maximum ultraviolet light absorption, are needed, such as in cosmetic sunscreens.

Mexican researchers sought to evaluate the effects of E171 across a span of conditions in mice, including its influence on behavior, along with the effects on the colon and liver. The research, published in 2020 in the journal Food and Chemical Toxicology, showed that E171 promoted anxiety and induced adenomas, or noncancerous tumors, in the colon. They also found that E171 heightened goblet cells hypertrophy and hyperplasia, which is typically seen in asthma patients and triggered by smoking or external pollutants and toxins. They also noted mucins overexpression in the mice, which can be linked to cancer cell formation. 

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