In a 2022 study published in the Journal of Hazardous Materials, scientists wanted to examine the effects of titanium dioxide as a food additive on atherosclerosis in mice. (Atherosclerosis refers to a hardening of the arteries.) Researchers fed mice 40 mg/kg of the food additive every day for 4 months, and found that it not only altered gut microbiota but also led to a significantly increased atherosclerotic lesion area, especially in animals that consumed a high-choline western diet (HCD).

The FDA first approved the use of titanium dioxide in food in 1966, following its 1960 removal (along with the removal of other color additives) from the agency's original Generally Recognized as Safe list. In 1977, titanium dioxide joined the list of color additives that are exempt from certification, which means titanium dioxide doesn't have to be listed on the packaging of every product it's used in, Faber noted.

In 2022, a year after the EFSA recommended against the use of E171, the Food Standards Australia New Zealand (FSANZ) conducted its own reassessment of titanium dioxide as a food additive. The agency concluded that titanium dioxide was indeed safe to use as a food additive. The United Kingdom and Canada came to similar conclusions.