In a 2016 study published in Scientifica (Cairo), Egyptian researchers examined the effects of titanium dioxide nanoparticles on the organs of mice by orally administering the food additive daily, for five days. The results showed that the exposure produced “mild to moderate changes in the cytoarchitecture of brain tissue in a time dependent manner.” Furthermore, “Comet assay revealed the apoptotic DNA fragmentation, while PCR-SSCP pattern and direct sequencing showed point mutation of Presenilin 1 gene at exon 5, gene linked to inherited forms of Alzheimer’s disease.” The researchers wrote: “From these findings, “the present study concluded that TiO2NPs is genotoxic and mutagenic to brain tissue which in turn might lead to Alzheimer’s disease incidence.”

Food safety experts in the European Union (EU) have recently updated their safety assessment of TiO₂ as a food additive. In Europe, TiO₂ is referred to as E171, in accordance with European labelling requirements for food additives. The EU expert panel took into account toxicity studies of TiO₂ nanoparticles, which to this point had not been considered relevant to the safety assessment of TiO₂ as a food additive.  

Following a request for assessment in 2020 by the EU, the European Food Safety Authority (EFSA) assessed E171, particularly for its genotoxicity. In 2022, the agency deemed the food additive no longer safe for use.  

The US and Canada, however, approve the use of titanium dioxide as a food additive. Canada's recent review of titanium dioxide reconfirmed its safety and pointed out that many of the toxicity studies the EU reviewed were not relevant to the safety of titanium dioxide as a food ingredient, and that the ban is based on an abundance of caution and uncertainty.