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.”

The trend in the production of NPs is likely to lead to increasing amounts of nano-powders in the air, water and soil, which will consequently affect living organisms. Labielle et al. demonstrated that 25 % of Al(OH)₃-coated TiO₂ particles from sunscreens are dispersed as a stable colloid and become available to microorganisms and filter-feeders, while the remaining 75 % are probably incorporated into geogenic sediments, where they could become available to benthic fauna. Solar UV iradiation may penetrate as far as 20 m in the water column  and therefore photo-activate the dispersed particles, which may have an adverse effect on various aquatic organisms.

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.

Titanium dioxide (E 171) is authorised as a food additive in the EU according to Annex II of Regulation (EC) No 1333/2008.  

Pigmentary TiO₂ particles are approximately 200-350nm in dimension and this form accounts for 98 percent of total production. It is used mainly for light scattering and surface opacity applications. It is used as a base for various colour paints or as a standalone ‘brilliant’ white.

Having thus described the origin and uses of the pigment, we now come to the question, what is lithopone? It is, in short, a chemical compound usually consisting of 30.5 per cent zinc sulphide, 1.5 per cent zinc oxide and 68 per cent barium sulphate, but these proportions vary slightly in the different makes. Lithopone of this composition is sold as the highest grade, either as red seal or green seal, as it best suits the idea of the manufacturer. Many manufacturers, especially in Europe, sell and also export other brands under other seals, containing 24, 20, 18 and as little as 12 per cent of zinc sulphide with very small percentages of zinc oxide, the balance being usually barium sulphate, but sometimes certain portions of China clay or gypsum (calcium sulphate) or whiting (calcium carbonate). Such brands are not a chemical compound, but mechanical mixtures of the chemically compounded lithopone and the admixtures referred to.

Some food products will include titanium dioxide on their nutrition label. But again, it can be hard to tell for those who don't list the ingredient. 

Following six months of phasing out the additive, titanium dioxide will be completely banned in the European Union starting August 7. France had previously banned the use of titanium dioxide in food starting in January 2020.