Swelling in hereditary angioedema (HAE) can arise from exposure to triggers like stress, infection, and injury. For some people, dietary triggers can also be a cause of HAE swelling episodes.
Hereditary angioedema (HAE) is a rare genetic disorder that causes periods of severe swelling in soft tissue. Locations like the face, mouth, airways, intestinal tract, and extremities are often affected.
While genetic mutations in the SERPING1 or Factor XII genes underlie the different types of HAE, specific triggers in daily life can prompt swelling episodes.
This happens because HAE impairs C1 inhibitor (C1-INH) function, leading to an excess of bradykinin. Bradykinin is a molecule that dilates your blood vessels and changes vessel permeability, allowing fluid to leak into surrounding tissues and create swelling.
When you encounter another source of inflammation — like a food intolerance — it stimulates the same pathways and promotes more bradykinin production that can worsen swelling.
Not everyone with HAE will experience dietary triggers, and certain foods may be more likely culprits than others.
Foods that trigger inflammation in your body could potentially trigger swelling when you live with HAE, but not everyone will have the same reactivity to the same types of foods or ingredients.
Older research from 2018 found that
- tomatoes
- green salad
- fish
- citrus fruits
- apples
- onions
- garlic
- cheese
- chili
- kiwi fruit
- milk
- tree nuts
- strawberries
- pineapple
- shrimp
- bread
- bananas
- leeks
- chicken
- alcohol
A more recent study from 2024 involving 30 participants found about one-third indicated a link between foods and HAE swelling. Foods cited as triggers included:
- legumes
- stone fruits (fruits with a hard pit, like peaches or cherries)
- wheat products
- spicy or acidic foods
- milk
Food triggers were associated with abdominal symptoms or swelling of the face, throat, extremities, or genitals.
In both studies, researchers indicate underlying food sensitivities and intolerances are likely to blame for HAE food-related episodes.
In the 2024 research, for example, four patients reported food allergies, two were lactose intolerant, and one was intolerant to sorbitol, a sugar molecule in certain vegetables and fruits that’s also used as a sweetener in sugar-free foods.
Foods often associated with inflammation
Certain foods and ingredients can trigger inflammation in anyone, regardless of HAE status. Common culprits of food-related inflammation include:
- sugar
- saturated fats
- trans fats
- omega 6 fatty acids
- refined carbohydrates
- monosodium glutamate (MSG)
- dairy
- alcohol
What are food allergies, sensitivities, and intolerances?
Food allergies happen when your immune system mistakes a food molecule as harmful and mounts an immune response against it. Allergies produce IgE (immunoglobulin E) antibodies which trigger histamine release.
Food sensitivities also involve immune system activation, but unlike an allergy, a food sensitivity doesn’t trigger IgE antibodies and leads to more low-grade inflammation.
Food intolerances are digestive system-related. When you’re intolerant to a food, it means your digestive system has difficulty breaking it down, often leading to gas, bloating, nausea, and stomach pain.
There’s no specific diet for HAE.
Your food choices will depend on your individual food allergies, sensitivities, and intolerances. Allergy testing, elimination diets, and laboratory tests such as blood tests or digestive enzyme testing are a few of the options available to help you create a dietary plan that works for you.
When you’re looking for foods to include in your diet, starting with those considered anti-inflammatory is a good place to start. Researchers and nutrition experts use frameworks like the dietary inflammatory index (DII) to calculate which foods are more likely than others to lead to inflammation.
Foods generally considered low on inflammatory scoring systems include:
- beans
- olive oil
- foods high in fiber
- fatty fish
- nuts and seeds
- legumes
- dark green, leafy vegetables
- certain berries
- whole grains
Just because a food is generally considered anti-inflammatory doesn’t mean it will be right for your HAE diet. In the research mentioned above, even foods typically seen as anti-inflammatory, like strawberries and green salads, were reported as HAE triggers.
It’s not always easy to figure out your individual food sensitivities, allergies, and intolerances. Your doctor or allergist can offer you several methods of testing to help pinpoint foods that might trigger inflammation.
Allergy testing uses skin prick tests, IgE blood tests, and oral food challenges to assess allergic reactions to specific foods and ingredients.
To help determine food sensitivities and intolerances, your doctor may recommend:
- keeping a food journal and noting what foods triggered symptoms
- food elimination diets
- lab testing, such as enzyme tests
Once you know which foods might trigger inflammation, working with a dietitian can help you formulate a plan that works for your HAE triggers and considers your overall nutritional needs.
HAE is a genetic condition that causes soft tissue swelling. Due to shared inflammatory pathways, certain foods and ingredients can trigger swelling in people with HAE.
Not everyone will experience HAE swelling episodes related to diet, but for those with underlying food allergies, intolerances, and sensitivities, being mindful of diet can help reduce episode frequency and severity.