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In a multi-center, single-blind, placebo-controlled cross-over study, we assessed the effect of the PPS on iron absorption from an extrinsically labelled test meal and test drink in patients (<jats:italic>n<\/jats:italic>\u2009=\u200914) with HH homozygous for the p.C282Y variant in the<jats:italic>HFE<\/jats:italic>gene. We measured fractional iron absorption (FIA) as stable iron isotope incorporation into erythrocytes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Black tea powder, cocoa powder and grape juice extract most effectively precipitated iron in vitro. A PPS mixture of these three extracts precipitated\u2009~\u200980% of iron when 2\u00a0g was added to a 500\u00a0g iron solution containing 20\u00a0\u00b5g\u00a0Fe\/g. In the iron absorption study, the PPS reduced FIA by\u2009~\u200940%: FIA from the meal consumed with the PPS was lower (3.01%\u00a0(1.60,\u00a05.64)) than with placebo (5.21%\u00a0(3.92,\u00a06.92)) (<jats:italic>p<\/jats:italic>\u2009=\u20090.026)), and FIA from the test drink with the PPS was lower (10.3%\u00a0(7.29\u00a014.6)) than with placebo (16.9% (12.8 22.2)) (<jats:italic>p<\/jats:italic>\u2009=\u20090.002).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our results indicate that when taken with meals, this natural PPS can decrease dietary iron absorption, and might thereby reduce body iron accumulation and the frequency of phlebotomy in patients with HH.<\/jats:p><jats:p>Trial registry: clinicaltrials.gov (registration date: 9.6.2019, NCT03990181).<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00394-022-02829-8","type":"journal-article","created":{"date-parts":[[2022,3,23]],"date-time":"2022-03-23T14:34:32Z","timestamp":1648046072000},"page":"2967-2977","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["The effect of a natural polyphenol supplement on iron absorption in adults with hereditary hemochromatosis"],"prefix":"10.1007","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7165-4576","authenticated-orcid":false,"given":"Simone","family":"Buerkli","sequence":"first","affiliation":[]},{"given":"Laura","family":"Salvioni","sequence":"additional","affiliation":[]},{"given":"Natalie","family":"Koller","sequence":"additional","affiliation":[]},{"given":"Christophe","family":"Zeder","sequence":"additional","affiliation":[]},{"given":"Maria Jos\u00e9","family":"Teles","sequence":"additional","affiliation":[]},{"given":"Gra\u00e7a","family":"Porto","sequence":"additional","affiliation":[]},{"given":"Jana Helena","family":"Habermann","sequence":"additional","affiliation":[]},{"given":"Irina L\u00e9a","family":"Dubach","sequence":"additional","affiliation":[]},{"given":"Florence","family":"Vallelian","sequence":"additional","affiliation":[]},{"given":"Beat M.","family":"Frey","sequence":"additional","affiliation":[]},{"given":"Diego","family":"Moretti","sequence":"additional","affiliation":[]},{"given":"Jeannine","family":"Baumgartner","sequence":"additional","affiliation":[]},{"given":"Michael B.","family":"Zimmermann","sequence":"additional","affiliation":[]}],"member":"297","published-online":{"date-parts":[[2022,3,23]]},"reference":[{"issue":"1","key":"2829_CR1","doi-asserted-by":"publisher","first-page":"328","DOI":"10.1002\/hep.24330","volume":"54","author":"BR Bacon","year":"2011","unstructured":"Bacon BR, Adams PC, Kowdley KV, Powell LW, Tavill AS (2011) Diagnosis and management of hemochromatosis: 2011 Practice guideline by the American Association for the Study of Liver Diseases. 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