Lithopone 30% has a lower coverage power than titanium dioxide. For this reason, Lithopone 30% can only partially substitute titanium dioxide, between 5 and 40%. 

In a 2017 study published in Scientific Reports, researchers exposed rats to human-relevant levels of E171 to examine the effects of intestinal inflammation and carcinogenesis. They saw that “a 100-day E171 treatment promoted colon microinflammation and initiated preneoplastic lesions while also fostering the growth of aberrant crypt foci in a chemically induced carcinogenesis model.” They continued: “Stimulation of immune cells isolated from Peyer’s Patches [which are clusters of lymphoid follicles found in the intestine] showed a decrease in Thelper (Th)-1 IFN-γ secretion, while splenic Th1/Th17 inflammatory responses sharply increased,” researchers wrote. “A 100-day titanium dioxide treatment promoted colon microinflammation and initiated preneoplastic lesions.” The scientists concluded: “These data should be considered for risk assessments of the susceptibility to Th17-driven autoimmune diseases and to colorectal cancer in humans exposed to TiO2 from dietary sources.”

In food, titanium dioxide is often used as an artificial color additive. Tasha Stoiber, senior scientist at the consumer health nonprofit Environmental Working Group, says titanium dioxide can generally be thought of as a paint primer – it often goes on a hard-shelled candy like Skittles before the color is added to give it a uniform shine.

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Of the products that include the additive in their labels, Thea Bourianne, senior manager at data consultant Label Insights, told Food Navigator USA in May 2021 that more than 11,000 products in the company's database of U.S. food and beverage products listed titanium dioxide as an ingredient. Non-chocolate candy led those numbers at 32%. Cupcakes and snack cakes made up 14%, followed by cookies at 8%, coated pretzels and trail mix at 7%, baking decorations at 6%, gum and mints at 4% and ice cream at 2%.

Titanium dioxide is one of the most widely used white pigments, often used to add whiteness and brightness to products. It is used in the production of paints, coatings, plastics and other products to provide a white color or opacity.

Although barium sulfate is almost completely inert, zinc sulfide degrades upon exposure to UV light, leading to darkening of the pigment. The severity of this UV reaction is dependent on a combination of two factors; how much zinc sulfide makes up the pigments formulation, and its total accumulated UV exposure. Depending on these factors the pigment itself can vary in shade over time, ranging from pure white all the way to grey or even black. To suppress this effect, a dopant may be used, such as a small amount of cobalt salts, which would be added to the formulation. This process creates cobalt-doped zinc sulfide. The cobalt salts help to stabilize zinc sulfide so it will not have as severe a reaction to UV exposure.

The use of titanium dioxide (TiO2) in factory settings is widespread, with this versatile compound playing a crucial role in various industrial processes. TiO2 is a naturally occurring mineral that is widely used as a white pigment in paints, coatings, plastics, paper, and other products. Its ability to effectively scatter light makes it an ideal choice for creating bright, durable, and long-lasting finishes.

In summary, the Food Directorate's position is that there is no conclusive scientific evidence that the food additive TiO₂ is a concern for human health. This is based on a review of the available scientific data relevant to food uses of TiO₂. However, we will continue to monitor the emerging science on the safety of TiO₂ as a food additive and may revisit our position if new scientific information becomes available.

After conducting a review of all the relevant available scientific evidence, EFSA concluded that a concern for genotoxicity of TiO₂ particles cannot be ruled out. Based on this concern, EFSA’s experts no longer consider titanium dioxide safe when used as a food additive. This means that an Acceptable Daily Intake (ADI ) cannot be established for E171.