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. 

Health Canada's Food Directorate recently completed a “state of the science” report on titanium dioxide (TiO₂) as a food additive. Food-grade TiO₂ is a white powder made up of small particles that has been permitted in Canada and internationally for many years as a food additive to whiten or brighten foods. Food-grade TiO₂ has long been considered safe in Canada and in other countries when eaten as part of the diet.

Below 10% substitution, 1 kg of TiO2 should be replaced by 1 kg of Lithopone 30%.  

What exactly is titanium dioxide?