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A New Era in Health Promotion: Nutrigenomics and the Microbiome

An Expert Interview with Dr. Karen Wolfe. In this interview, Dr. Karen Wolfe shares her expertise in understanding the role of nutrition on gene expression and the potential for personalized health promotion programs based on genomics. Learn how science helps explain how we are all different and get the latest information on using genomics to revolutionize overall wellness through your worksite wellness programs.


WELCOA visits with Dr. Karen Wolfe, trained as an Australian physician and now living in California, she is also an entrepreneur, Healthy Lifestyle Coach, author and international speaker. She is helping us gain an understanding of the role of nutrition on gene expression, and the potential for personalized health promotion programs based on genomics. Learn how to finally put science to the idea that we are all different, and we respond differently to lifestyle recommendations, and use genomics to revolutionize dietary recommendations, exercise plans and other behavioral and lifestyle interventions to help improve overall wellness through your worksite wellness programs.

A New Era in Health Promotion: Nutrigenomics and the Microbiome
An Expert Interview with Dr. Karen Wolfe

Sara Martin Rauch Hi, Dr. Karen. Thank you for joining me today.

Dr. Karen Wolfe Oh, you’re welcome.

SMR It is an exciting time to have this conversation, because I think that our topic today is one that’s getting a lot of murmuring about in the health promotion community. I think there’s a lot of confusion about what it might mean for the future of our industry. I’m really excited that you can educate us, maybe dispel some myths, tell us what we need to be thinking about for the future, and get us excited about possibilities for genomics and nutrigenomics, and what it can mean for our nutritional futures. So, thank you.

KW You’re welcome. I love talking about this; it’s an exciting time to be in wellness, that’s for sure.

SMR I know, it’s very futuristic. So, just a bit of background. You’re a physician by trade, but you have a pretty unique and exciting area of specialty. So, could you start by telling us a little bit about that?

KW Well, yes. I went to medical school in Australia. I was a general practitioner “Down Under”, before I came to the United States. I came to the United States for love, just to clear that up. People wonder, “Well, how did you come to be here?” That’s a whole other story that we could do a really fun podcast about, the health benefits of love. But, yes, I came for love and it’s worked out really well for me, by the way. Still married 26 years to the love of my life, and we have a beautiful adult daughter.

When I came to the United States, I really had to rethink, “Okay, so do I just keep doing what I’ve always done?” and I’d have to do a residency again and the exams – and I would have done that if that’s really what my heart called me to do. But I really stopped and had that watershed moment. I think many of us had the opportunity in our lives, in different circumstances, to rethink – and I realized that “disease care” medicine was really not my greatest calling, but I’m glad it is for many, because it’s really important. My big interest was a big question, which is, “What creates health?”

I was always an athlete. I was a swimmer for Australia, so I was always interested in performance and how to get the most out of your body, as you do when you’re a high-level athlete.

I decided to go in the direction of wellness, and I found, that managed care was very big on wellness because the healthier that employees are, the lower the healthcare costs. So, it was a big industry 25 years ago, and I became fascinated by the wellness industry, and then with health coaching. I moved more in the direction of health coaching which I believe is more empowering than the didactic approach of telling people what to do.

I found that I really loved educating and being a teacher, and I found if people had the right information, then they could really make better decisions for themselves.

That’s really what got me started in the health promotion field, with that big question of, “What creates health?”

And of course, that question itself, over 25 years, has changed a lot. Twenty five years ago, I wasn’t talking about nutrigenomics, but now realize that food is medicine. I wasn’t thinking about this in medical school. But looking at food and nutrition and how it relates to health, and chronic disease for that matter, it is a huge area of study right now, and I believe it needs more focus.

And that’s what’s new to me in this particular field with nutrition skills. I just love it, and I am learning something new every day as it’s exploding in this wellness space. And we cannot talk about nutrigenomics without also talking about the microbiome. So, I will be talking about those two together as we go further into the exploration of what nutrigenomics is all about.

SMR There’s new information all of the time that shifts our perspective. And you mentioned that you really wanted to know what created health in the first place. Was there something specific that happened? Was there an inciting factor or a moment that you can recall that got you really fired up or interested in prevention as opposed to more of the healthcare space?

KW Yes, I must say that it was when I was in medical school, in my residency. I knew then that it was probably not my greatest calling when I would do rounds and just see chronic disease everywhere, from cancer to autoimmune conditions. All we could do as doctors was try to put band aids on problems. And back then, I started to question, “Well, what created this in the first place? Why are we getting this looming cancer and chronic disease epidemic?” And as doctors in medical school, I was never trained to look at that end of medicine. I knew it early on that I really wanted to explore that deeper question.

But sometimes, you get on the roller-coaster. If I had not moved to the United States I may never have had that chance to re-choose what I wanted to do. I knew that it wasn’t my exact right calling, so let me choose again. That’s when I followed my true heart. I followed what was true for me. I will say to everyone, I do believe that we have many careers and many opportunities in our lives. Whether it’s divorce, moving, failing an exam and realizing, “Well, maybe I wasn’t meant to do this in the first place.” We re-choose what we do so that what we are doing is more in alignment with who we really are in our authentic self.

I truly believe that this is what I’m meant to do – looking at what creates health and what are the underlying functional aspects of the body.

I’ve become interested in functional medicine which is looking at the root cause of illness – and it’s usually around lifestyle. And I just get really excited about that.

So, I’ve followed what I’m really excited about, and I’ve stopped doing things that don’t excite me. That’s really what keeps leading me in this direction which, as you said, continues to change and grow. I’m learning all the time, which I think is also really important. Wherever we are in this journey in health promotion, to realize we only know what we know, and it’s going to change, and we’re going to continue to learn new information.

SMR Two things that you said there, that I wish we could do a full interview on– is this idea of choosing and then choosing again, which I think is such a valuable lesson that many of us are afraid to do.

But then, I also really love what you said – and we talk about this a lot too at WELCOA, the importance, in terms of wellness at work, is giving employees the right to work within their strengths and how when we do betray what we know is truly our first goal, what we’re really called to do. That’s when all those awful things we want to prevent happen, like burnout and depression, and ultimately physical health issues come into play.

KW I mentioned coaching just briefly, but I do believe one of the watershed moments for me was when I did my very first coaching training 20 years ago. Instead of just telling people what to do – which I was trained in as doctor – you’re telling people what to do, because you have the little short windows of time with people. “So, you’ve got to do this, and this, and this.” Whereas the coach approach asks these powerful questions, “What is it that you think is the right thing for you right now?”

And that made a huge shift in me because I realized that I don’t have the answers for anybody else, but if I hold the space in a very loving, safe, environment, to ask someone, “What is your next best right steps?” you get better results. It’s just truly miraculous.

That’s what was the big watershed moment for me. I realized that the coach approach was an empowerment for us all. That we don’t have the answers for anybody else, but if we hold that space, we can help people find the answers for themselves.

SMR Absolutely. As a physician you had one kind of conversation with individuals, and as a coach, you had different kinds of conversations, and then now, with a lot of your work doing keynotes and other consultative things to organizations, you have even different kinds of conversations about strategies at the public or organization level. What have you learned about the health of our workforce or what concerns do you have as you’ve learned more about the health of the American workforce?

KW Well, in line with what we’ve just said, is disempowerment. I think many people feel that they’re not valued, that they’re not living their authentic life and that their unique gifts and talents are not being expressed in the workforce. Their transformation, in my opinion, can take place in the workforce if we stop and value people, and ask them these questions, “What are your unique gifts, and talents, and strengths? How can they be expressed here?” The key is to be able to value people and help them be more empowered so that they feel that this job that they’re in is in alignment with their authentic self.

Then, you’ve got a powerful, trusted and loyal employee, because the work that they do is in alignment with their life’s calling. For some reason, what just jumped into my head was, a long time ago, a beautiful lady, Elaine Sullivan, talked to me about Parker Palmer’s work. Parker Palmer has this book called Let Your Life Speak. And he talks about vocation – which is a beautiful word which we use – and it’s something that I have memorized. I ask these questions to keep checking in with myself;

“Is this my true path? Do I need do make adjustments?” It’s been said that vocation is when your deep gladness meets the world’s deep need.

In other words, what brings me joy and meaning, meets a need in the world. When you align those two things, I think we’re going to have a more successful workforce. I encourage people to look at Parker Palmer’s work, Let Your Life Speak: Listening for the Voice of Vocation. So, I guess that’s somewhat philosophical, but I think we’ve got to start at that deep place and value people, because people are human capital as we like to say. And we’ve kind of forgotten that somewhat in the drive to be financially viable.

SMR I love that definition. I think a lot of people might have expected that you would have talked about more traditional health markers, but I think it’s powerful that you started with that sense of value and meaning. But what else do think practitioners, health educators, and health promotion professionals should we be considering at this point, when trying to be a transformative force in the workplace?

KW Well, that’s a big question. I guess the answer is lifestyle medicine, or what I might call lifestyle health promotion. Let me get down to the nitty-gritty of looking at where health promotion is headed at this time. We talk a lot about exercise prescription, diets and weight management. In fact, I’d really encourage people to watch the language that they use moving forward. I don’t like “weight management” as a term, and I don’t like “prescriptive exercise”. I like personalization.

We are moving into an era in both medicine and in health promotion – because they’re very much aligned in the direction they’re headed – called personalized or what we call “precision health promotion”, which is looking at the individual, who they are, and matching the health promotion strategy with them.

We have so many tools! That’s where nutrigenomics does come in to help us with that, to personalize so that one size does not fit all. Everyone is unique and has a unique value proposition that goes with their particular health promotion recommendation. I’d encourage anyone in the health promotion field to keep up with the science of nutrigenomics and the microbiome, because this is the science of precision wellness and precision health promotion!

It’s kind of a whole new lens of the 21st century that we are moving into that is breaking down a lot of paradigms of what we thought was correct. We have to rethink what we’re recommending.

SMR Exactly! What do we, as health promotion professionals really need to know about nutrigenomics? And we’ll talk about microbiomes too.

KW Just so everybody knows, I’m not a researcher doing research in that field. I see myself as a health educator, and I love to take complex topics and make them understandable to the everyday person so that we can apply them and use them in a practical way. My goal is in educating.

Nutrigenomics, if you break that word down,

“nutri” refers to nutrition, “genomics”, refers to the genome. The simple way to think of that is how our foods affects our genes. If we want to take it further – which I kind of like to – I consider nutrition as everything we do to nourish our lives.

In fact, I consider it in a more expansive way, as everything we do in our lifestyle: sleep, our digestive health, our exercise, our whole external environment; all of that is speaking to our genes all of the time, and that’s called epigenetics. The field of epigenetics really means that our genome is very fluid.

So, the old paradigm is that we had these genes, and that we’re victims of our heredity. That’s old science. Our genome is very plastic, so to speak – it’s very fluid. And everything we do in our life is talking to our genes all of the time, and basically makes decisions. Our lifestyle makes decisions whether certain genes are switched on or switched off. We actually have the ability to switch on and off certain genes. In nutrigenomics, specifically, there’s a deep study going on about specific aspects of nutrition and what enables genes that want to switch on and what genes we might want to switch off, or changing constantly. We have to be super careful that we don’t get into the all-or-nothing thinking.

In science, we tend to jump into black and white thinking, and think that, “Okay, so we’ve got this gene, and that means we are predisposed to something, or does it mean we’re going to get it?” I’ll give you a specific example. There’s a particular gene called the APOE gene 4. Some people might have heard about it, and it’s specifically talked about when we’re talking about Alzheimer’s.

In health promotion, one of the things that we’re really concerned about is brain health, of course, and the increasing rate of dementia, and we want to keep our brains alive for as long as possible. So, people are saying, “Wow, let’s see whether we have this gene or not, and see if we’re going to get Alzheimer’s.” I don’t want people to jump to this conclusion, because genetic information is just information, and we have the ability to switch on or off that gene.

This particular gene is simply a marker for Alzheimer’s disease. The APOE4 allele, present in approximately 10-15% of people, increases the risk for Alzheimer’s and lowers the age of onset. And a marker means that if we know we have that gene, then there are certain lifestyle factors that can affect it, and that’s where the health promotion industry has a huge opportunity.

Nutrigenomics is actually opening doors for health promotion that were not open before.

Because you might have a gene like APOE4, it’s up to our lifestyle choices whether we switch that gene off. It turns out that a person that has this APOE4, is highly susceptible to a diet high in saturated fats, sugar, and a sedentary lifestyle. Three things that we do all of the time in health promotion; we’re teaching people to eat healthy fats and reduce saturated fats and sugars, and exercise. But it turns out that if we don’t do all that, and we have this genetic marker that’s being tested for, then maybe people will be more compliant now, because they know that doing this health promotion could potentially silence this gene that can precipitate Alzheimer’s.

The truth is that health promotion has a powerful opportunity, and that’s what I want people to see in this nutrigenomics space. You don’t have to know all the complicated science of genetics, because it’s hugely complicated. Brilliant people are doing this research, and thank goodness they are. But for us in health promotion, we want the bottom line, which is, “Okay, someone has a genetic test, and what can we do in health promotion that can switch off that gene that we don’t want expressed?” I do believe that it’s going to add to increased compliance with our health promotion strategy, because people are more empowered with information.

SMR I think what’s interesting about what I’m hearing too, for those of us who may still be doubting the role of epigenetics in health, whether we are right or not, the lifestyle behaviors that health promotion professionals are trying to encourage in our population, are impacting our genetics, even if we’re never thinking about it one way or the other.

KW Yes. And don’t worry that the intense science of it – because the science of this, as I said, is super, super complex, and there are brilliant people doing amazing work. Our job in health promotion is to take the information and educate.

Another thing that’s really important, are all single-nucleotide polymorphism (SNPs), which are little changes on the gene. I liken it to changes in a word. Imagine changes in a word that make a huge difference in the word. A SNP is just a little change in the alphabet of a gene, and what we’re looking at is those SNPs that have been most researched that we can now utilize in action.

There are only about 80 or so SNPs that most of the genetic companies are realizing and saying, “Okay, these are the most important ones that we can actually utilize and take actions,” like the APOE4 I just mentioned. If someone has a genetic test and they see that they have the APOE4 allele, as health promotion specialists, we can say, “Okay, so this is what we know. That diet and certain environmental factors are powerful modulators of that gene. So, let’s look at how we can customize your health promotion program, so that we keep that gene silent.” To be able to work with those genes that we have a body of evidence for. In this field, it’s changing all the time. We are getting information here and there, that there is a body of evidence of certain SNPs that they are pretty sure that health promotion can make a significant change in.

SMR For those who aren’t familiar with the power that nutrition has on genetics, and then, in turn, the power that that would have on prevention for chronic illness – is there another great specific example of that relationship that you can talk more about to give us a sense of what the opportunity is here?

KW Yes. Let me just define some terms, and I’ll certainly be doing this in my certification. There are three words that I just want people to understand; nutrigenetics, nutrigenomics, and epigenetics.

Nutrigenetics is just looking at the genes and saying, “Okay, this is what’s showing up,” like the APOE4.

Nutrigenomics is how the genes are behaving Do we want to silence it, like that APOE4 gene? Do we want to switch it on or do we want to switch it off? How are they behaving.

Epigenetics is how we can use the whole environment: diet and exercise, stress, and all of these health promotions that we all love to do, how does that impact our genes?

It’s really important to know those three different things and it’s part of why we’re doing this certification. It is just to learn the basic terms, to get a basic understanding about these skills so that you can really then pursue it at the level that you’re most interested.

Another example some people might have heard about, is the MTHFR which is really long name methyltetrahydrofolate reductase. It’s extremely influential in controlling the metabolism of folic acid. And there’s a lot of discussion about this. People with this particular SNP, their metabolism of folic acids is modified in some way. It’s believed that if you have this SNP, that you could be more predisposed to depression, heart disease, or dementia, so how we recommend the level of folic acid through food and supplementation might be different if you have this SNP or not, and that’s certainly in nutrigenomics.

Another really good example is vitamin D. Everybody is talking about the vitamin D that we need. It’s actually a hormone, and it’s related very much to our immune system. In fact, the higher your level of vitamin D, the more immune protection you have and most people are deficient in vitamin D, especially up in those northern states that don’t get a lot of sunlight.

It turns out that you could take a lot of vitamin D supplementation and yet your blood level does not increase. There’s a certain SNP that regulates your metabolism of vitamin D. So, knowing whether you have the SNP or not, could help with knowing the dose of vitamin D you need to get a level that gives you good immune protection, which is different than before when we thought one-size-fits-all. We’ll let you take a certain amount of vitamin D and your vitamin D level should increase. But if you had this SNP, then you may need more help to get enough vitamin D.

I have had some genetic testing done myself. I always like to walk my talk and be able to understand this from my personal perspective, and I did have that vitamin D SNP. Here I am, an Australian, a swimmer, outdoors a lot. I get plenty of sunshine – I live in southern California and I couldn’t get my vitamin D level up. The reason, now I see, is this SNP that interferes with me being able to process the vitamin D, so it was very helpful for me to understand why my vitamin D wasn’t going up, and so I need higher doses.

These are just a few examples of how we can use these in health promotion, and ones that are used most often, MTHFR and the vitamin D SNP. We talk about bone health a lot and hopefully, these different discussions would help people in health promotion realize the value of some good genetic testing.

In bone health, there is a bone marker that, if you have it, then caffeine can significantly impact your bone health. So, if you have that bone marker, it would be recommended that you reduce your caffeine intake because it’s affecting your bone health. So, you have a bone density scan and maybe you are osteopenic. If you also know that you have this genetic marker, then you’ve got to reduce your caffeine and look at your vitamin D status. Maybe do more weight-bearing activity to overcome this marker. It is an adjunct. Let’s just say that knowing some of these high-level genetic markers can be a great partner for our health promotion work.

We can certainly talk about some of the pitfalls of genetic testing in this space. You’ve got to be a wise consumer in this space as well. I’m just giving some exciting areas right now

SMR In the world of corporate health promotion, we talk a lot about how it’s important to recognize that there’s no such thing as a one-size-fits-all approach. In terms of actually shaping our work in the corporate space, what’s your vision for how we can use these concepts – the science of epigenetics, nutrigenetics, and nutrigenomics – to really make a difference within that environment?

KW Well, there are some companies that are offering their employees certain genetic testing – and when I say “certain genetic testing” you can imagine it’s all kinds of levels. There are many versions of genetic testing. And what they’re doing in their corporate health promotion space, is they’re offering this genetic testing, and then they’re offering counselors.

If you do genetic testing, you’ve got to ensure certain things like privacy, how they’re going to use that information, and how they’re going to act on it to actually make a difference.

I’ve actually attended a summit about this where a company spoke about how they’re using genetic testing. What they’re finding, first of all, is that employees value it because they realize that this is personalized wellness. It is not a one-size-fits-all, but they’re looking at them and caring about who they are and what their specific needs are. The modifications of the recommendations of health promotion change based on the results of that individual genetic testing. It’s improving the health of that workforce because of the targeted nature of the health promotion recommendation. This is a fairly new concept of course, and it can be costly for companies. They’ve got to weigh up the cost benefit to the employees in terms of loyalty and absenteeism for this targeted health promotion work. But it is happening in the workplace; more and more companies are looking at this as a potential adjunct to their health promotion work.

SMR So, you’re getting at the impact from a health perspective and impact from a cultural perspective in terms of advantages. Are there other advantages that you didn’t mention for worksites to engage in these more personalized health and wellness strategies?

KW I think what you do with the data is super, super important. If companies are deciding to do some genetic testing, they’ve got to be ready with how their employees interact with the data. And I’ve mentioned nutrigenomics with having specific food plans, but with genomics, and the testing that I did, I also had an exercise profile done where it showed me the best kinds of exercise that I could do for my particular genetic make-up. That was super, super useful. And also, if you process caffeine fast or slow.

But the companies need to have their health promotion strategies so that the employees are assisted in interacting with the data, and focusing on the behavior change that is in alignment with the data. It’s not just a matter of doing a test.

This is a huge benefit to the human resource management of a company; that they would care enough about their employees to offer such an amazing resource to help you maximize your genetic potential in every way that’s going to help your life in general.

So, I think it does position an employer and an employee in a whole new relationship of trust and caring. That’s how we started this conversation: about everyone’s unique strengths and potential, and look at what we’re offering here, the personalization of that through this field of genomics.

SMR I think one of the downfalls that we’ve been dealing with is when we first rolled out any kind of screening in the corporate space, a lot of our language was very similar. Corporations are saying, “We care about your health, and we want you to understand more about your health so you can manage it better.” But unfortunately, that’s not how a lot of these tools were interpreted by employees.

What we ended up doing with a lot of the data was making it very complicated around total population health, charting graphs, and reports and it ended up feeling less personalized and a lot of more population health prescriptive.

I think that genetic information becomes even scarier to many employees than biometrics, and we have to get that messaging right. What do you think are those major risks, and how do you think we mitigate them if we’re going to bring these kinds of tests into the workplace?

KW I think it’s really great that we’re talking about this, because this has to be addressed at exactly the same time. We can’t have these questions asked later.

A lot of it comes down to whom the company collaborated with. Remember, this genetic testing is going to be done by some kind of partner that the company chooses, and there’s a lot of them in this genomic space. They are coming out of the woodwork, realizing this is the new era of health promotion, and an employer has to decide. So, that’s the first choice, which can be hard because there are so many. And one of the reasons it’s exploding is because the implications for what we’re talking about. This specific, personalized genomic platform. This is the new area for pharmaceutical medicine where pharmaceutical drugs are going to target specific genomic packets. So, you can only imagine what an explosion that it is.

The worksite wellness platform has to collaborate with a certain company, and it’s up to that genomic company to make sure that privacy information is crystal clear. They should be very clear about where the information is going to be used, the databases that are collected, where is the information going to be stored, and how they’re going to use it. You’ll want to know the standards they’re going to use. What SNPs are going to be used and why? I talked about a few of the SNPs. The genomics company has to explain, “Okay, we’re going to test these particular SNPs, because this is a body of evidence we have”, and the company has to be okay with that.

Then, how is the employee going to interact with the data? Who’s going to be counseling them? Or is the report that’s generated going to be comprehensive enough for the employee to take action? I don’t think people just get a paper report and then off they go. They have to have a coach’s support, which is why these new areas of genomics is the big opportunity of health coaches. It’s a health coach’s job to be able to look at the report and say, “Okay, so which of all these do you want to take action, and support people to take action?”

And then focus on change in behavior, and also make sure, from a psychosocial perspective, that a report doesn’t appear, and someone sees the APOE4 gene, and they say, “Oh, I’m going to get Alzheimer’s disease.” It’s very possible, that people interpret their reports and go straight to the all-or-nothing thinking. They don’t realize that just because they have a gene does not mean they’re going to get a disease.

How the employee interacts with the data, and how the employer interacts with genomic company need to be worked out up front.

These are the kinds of things explain why you’re bringing this topic to the forefront. This is all so new for people. You don’t just want dive in; you’ve got to really be thinking about all these issues ahead of time.

SMR Absolutely. I think that as people get more and more comfortable with these ideas, these questions are going to keep coming up repeatedly. What’s exciting is the ability to customize and personalize care and recommendations for lifestyle behavior changes at the individual level.

KW I do want people to realize that at this point in the evolution of nutrigenomics, in my opinion; we have more questions than answers. And that’s, sometimes, really an uncomfortable place for people to sit. I came from the medical model where we had to have all the answers. And you’ve got to become used to being uncomfortable in this space of not knowing and just keep asking questions. And just when I said to you, “Oh we can have your genome tested, and you can see the SNPs you have,” we have to bring in another player, which is called the microbiome, also called “our second genome.”

I want you to expand your minds right now and get ready for where we’re about to go, because we’re going to take this deep dive into another whole big question.

Did you know all the bugs that live in our body (your microbiome), outnumber our human cells by 10 to 1?

We have more microbes in our body than human cells. In fact, the human body is only about 25 percent human cells and those microbes incorporate another 3.3 million genes into our body.

So, here we are testing the human genome, and we have forgotten that the microbiome has another 3.3 million genes. In fact, the microbiome genes outnumber our human genes by 150 microbial genes to 1 gene. So, the big question is, “Well, what about all the genetic material from the microbiome? What does that all mean to our health?” And it’s still the microbiome, and our second genome, is exploding with these question, that we cannot ignore that the genetic makeup of our microbiome is also hugely influential in our health. It’s probably as important as the human genome.

All this research is being done on exploring the role of the microbiome in every aspect of our health. That makes my brain hurt – how big that question is. For health promotion, we have to embrace the microbiome and realized that these bugs live inside of us. We know that diversity is super important, and that the more diverse a microbiome we have, the more healthy we are, and bringing this conversation into every aspect of health promotion is so important. We know enough now to know that the microbiome plays a role in every aspect of our health and wellness.

We weren’t taught this because most of us that had our training before we even realized this organ existed – and it is considered another organ. We’ve got to bring the microbiome into the conversation. I will be talking more about that in the certification and then coming down to that question of, “So, how can we optimize the health of our microbiome?” While we’re exploring the genetic makeup of it, there are certain things we can do to improve the health of our microbiome. It’s all about health promotion.

We play a central role in this explosion in medicine called nutrigenomics and the microbiome. Health promotion professionals are going to be making practical, what we do with the science.

SMR I cannot think of a more exciting way to end this conversation than what you just said. There’s so much that we don’t know, and so I think people are going to be so excited to tune in with the certification to learn more about the microbiome, to learn more about everything else that we’ve been talking about today. You’ve so beautifully tasked them with understanding it because of how central our industry is going to be in making this brand new world for the healthcare space; making it real. I think now, more than ever, our role is really an exciting one when it comes to health promotion, because we’re going to be figuring out how to make a lot of this stuff impact the health of the people who could benefit from it, as opposed to just living in the research space.

About Dr. Karen Wolfe

Dr. Karen Wolfe

Dr. Karen Wolfe is an Australian physician, entrepreneur, Healthy Lifestyle Coach, author and international speaker. Dr. Karen was born in Sydney, Australia and graduated from Sydney University with a Bachelor of Medicine and Bachelor of Surgery and completed a Master’s Degree in Psychology from National University in California.

After working initially in Australia as a family physician, Dr. Karen moved to the United States in 1991 and began her wellness career in corporate wellness. She assisted companies and school districts reduce health care costs by customizing wellness programs to improve the health and well-being of employees.

She graduated from the Institute for Integrative Nutrition and is a Holistic Health Coach. In 2016, she was awarded the Lifetime Achievement Award by The National Wellness Institute and was inducted into the Service and Leadership Circle as recognition of her contributions to the field of wellness.

Dr. Karen is the author of seven books which include Is Your Lifestyle Killing You?, From Stress to Strength and Medicine from the Inside Out. She is an international speaker on stress management, wellness and nutrition. Dr. Karen cares that her audience understand and apply the principles she teaches and her presentations. She often include demonstrations and participation that bring personal meaning to her audience members.

Dr. Karen now lives in California and speaks and writes on health and wellness. Her mission is to inspire people to proactively optimize health in order to live with personal power, purpose and passion.


Parker J. Palmer. Let Your Life Speak: Listening for the Voice of Vocation. Jossey-Bass, 1999.


Michaelson, D.M., APOE epsilon4: the most prevalent yet understudied risk factor for Alzheimer’s disease. Alzheimers Dement, 2014. 10(6): p. 861-8.

SNPs – Single Nucleotide Polymorphisms:


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