The inhibitory effects of a standarized apple peel polyphenol-rich extract (APPE) against Helicobacter pylori infection and vacuolating bacterial toxin (VacA) induced vacuolation were investigated. Apple peel polyphenols significantly prevented vacuolation in HeLa cells with an IC(50) value of 390 microg of gallic acid equivalents (GAE)/mL. APPE also displayed an in vitro antiadhesive effect against H. pylori. A significant inhibition was observed with a 20-60% reduction of H. pylori attachment at concentrations between 0.250 and 5 mg of GAE/mL. In a short-term infection model (C57BL6/J mice), two levels of APPE doses (150 and 300 mg/kg/day) showed an inhibitory effect on H. pylori attachment. Orally administered apple peel polyphenols also showed an anti-inflammatory effect on H. pylori-associated gastritis, lowering malondialdehyde levels and gastritis scores.