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. 

While loose titanium dioxide presents a problem, titanium dioxide within sunscreen formulations presents a much safer option than conventional sunscreen chemicals like oxybenzone and octinoxate. However, titanium dioxide may become dangerous when it is nanoparticle size. Generally, nanoparticles can be 1000 times smaller than the width of a human hair. Despite nanoparticles becoming increasingly common across industries, they have not been properly assessed for human or environmental health effects, nor are they adequately regulated. Researchers don’t quite understand the impacts nanoparticles could have on human health and the environment. However, because of their infinitesimally small size, nanoparticles may be more chemically reactive and therefore more bioavailable, and may behave differently than larger particles of the same substance; these characteristics may lead to potential damage in the human body or ecosystem.

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).