Overall, the Food Directorate's comprehensive review of the available science of TiO₂ as a food additive showed:

It's sort of ironic, maybe ironic is the wrong word, that the ingredient in paint that makes your kitchen shiny also makes your Hostess cupcakes shiny, Environmental Working Group's senior vice president of government affairs Scott Faber added.

All in all, Titanium Dioxide is a famous sunscreen agent and for good reason, it gives broad spectrum UV protection (best at UVB and UVA II), it's highly stable, and it has a good safety profile. It's definitely one of the best UV-filter agents we have today, especially in the US where new-generation Tinosorb filters are not (yet) approved. 

Increased severity of ulcerative colitis

In a study published in the journal Environmental Toxicology and Pharmacology in 2020, researchers examined the effects of food additives titanium dioxide and silica on the intestinal tract by grouping and feeding mice three different food-grade particles — micro-TiO2, nano-TiO2, and nano-SiO2.  With all three groups, researchers observed changes in the gut microbiota, particularly mucus-associated bacteria. Furthermore, all three groups experienced inflammatory damage to the intestine, but the nano-TiO2 displayed the most pronounced changes. The researchers wrote: “Our results suggest that the toxic effects on the intestine were due to reduced intestinal mucus barrier function and an increase in metabolite lipopolysaccharides which activated the expression of inflammatory factors downstream. In mice exposed to nano-TiO2, the intestinal PKC/TLR4/NF-κB signaling pathway was activated. These findings will raise awareness of toxicities associated with the use of food-grade TiO2 and SiO2.”