Episode 144 | Aug 21, 2025

Why Health Coaching Is the Heart of Healthcare, With Karen Malkin

What does it take to be at the forefront of a profession that is transforming healthcare? This week on Health Coach Talk, Dr. Sandi welcomes Karen Malkin, one of the first National Board Certified Health and Wellness Coaches in the United States. Karen has spent years weaving together nutrition, environmental health, and brain health into her coaching practice, helping clients create sustainable lifestyle changes and even guiding those working to prevent or reverse cognitive decline.

“The health coach is going to help the physician be much more successful with patients, because compliance is difficult when there’s limited time. Having a health coach helps create small changes that add up — we’re helping people create behavior change, and it takes time.”

Karen Malkin

Karen’s own path to health coaching began with a lifelong passion for healthy living and nutrition. After raising four sons, she pursued further education, training in mind-body coaching, precision medicine, and integrative health. Her journey was also deeply personal, as her father’s experience with Alzheimer’s disease inspired her to study Dr. Dale Bredesen’s ReCODE protocol. Today, she specializes in supporting clients navigating brain health challenges, while also advocating for integrative and environmental health initiatives on national boards and councils.

In her conversation with Dr. Sandi, Karen highlights what makes health coaching unique: the client-centered process that sparks “aha” moments, builds self-efficacy, and supports lasting behavior change. She shares how coaches play a vital role on healthcare teams by bridging the gap between physician recommendations and patient follow-through. Karen also opens up about her philanthropic work, her food company featuring clean protein snacks, and her dedication to educating the public about the impact of environmental toxins on health.

For health coaches, Karen’s story is a reminder of both the power and responsibility of this profession. From brain health coaching to environmental awareness, her work underscores how coaches can transform lives, empower clients, and even shift the future of healthcare. Her insights offer encouragement for coaches to embrace their own passions and bring them into their practice.

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Transcript

Dr. Sandi: My mission is to grow the health coaching profession, to make it a household name, to encourage people to work with a coach, as well as to help providers hire one or refer to a coach in their community, because we believe that coaches are the key to helping people deal with chronic illness and lower health care costs. And one of the ways that I feel I serve my mission is to introduce you to health coaches from all over the world who are doing fascinating things, who are really making a difference in the lives of their clients and in their communities.

That’s why I’m so excited to bring to you my special guest today. She is a health coach, and she was one of the first to be certified by the National Board for Health and Wellness Coaching. She studied health coaching many years ago. I knew her probably 15 years ago, and she was out in the community helping people make better choices, living healthier lives.

Let me tell you about my guest, Karen Malkin. She is, as I said, among the first National Board-certified health and wellness coaches in our country. Karen completed a fellowship in precision medicine and genomics and is a certified 2.0 ReCODE Brain Health Coach, helping her clients prevent and reverse cognitive decline. She has a Master of Arts in Health Coaching from the Maryland University of Integrative Health.

Karen is also the founder of a food company, Karen’s Homemade Health, containing vegan protein blends, MCT oil, and superfood protein bars. Passionate about integrative medicine and environmental health, Karen serves on the philanthropic council for the Osher Center for Integrative Medicine at Northwestern Medicine, is on the Board of Directors of the Environmental Working Group, and she serves on plenty of committees contributing to strategic initiatives for the Andrew Weil Center for Integrative Medicine.

Some of Karen’s specialty areas include brain health, environmental health, her 14-Day Transformation series, emotional eating, weight loss, the science of nutrition, high-energy superfoods, smoothies, managing cravings, and healthy lifestyle makeovers.

It is my pleasure to welcome Karen Malkin. I know that you will enjoy this episode as much as I enjoyed my conversation with Karen. So, welcome, Karen.

Karen: Thank you, Sandi. And I have to also just acknowledge you for your amazing podcast. I think every person I listen to, who you interview, I’m learning from, and I’m almost finished with your book. So, kudos to you and congratulations for all you’re doing for the health coaching movement.

Dr. Sandi: Thank you. That means a lot. So, in fact, we personally go back a long time. I think it was well over 10, maybe 13, 14 years ago or so, and I first learned of your work. And at the time I was practicing as a health psychologist, and we are both in the same area of the country, and always admired you and the work you were doing. So, let’s go back and talk about, if you will, how you got into this field. How did this all start at a time when health coaching was not well known?

Karen: Well, I always had a passion for movement and diet. And I learned at a very young age what healthy eating, how it impacted my body and my mind and my energy. And the same with exercise. And so I always use myself as my own experiment around what I eat and how I feel and how I move and how I feel. And I developed a passion for healthy living at a very young age.

After I had finished raising my sons, my four sons, they went off to college, I decided to go back for some more education. My passion was in nutrition. I had a background in college in nutrition. And so I went back to school to the Institute for the Psychology of Eating. I spent my weekends in New York City. And then I did every one of Mark David’s trainings at the Institute for the Psychology of Eating. And I became a mind-body coach, and I helped people create a healthy relationship with food.

And from there, I went on to a fellowship in precision medicine with Wild Health and onto the Andrew Weil Center for Integrative Medicine and completed their health coach training and their integrative lifestyle practitioner. And I feel like this time in my life, I just have this immense thirst for living. And I feel like I have these gifts that I want to share with others. This gift of healthy living, I know, I believe in my heart and soul, it is the way to live.

Dr. Sandi: I could not agree more. And the world needs people like you because of these chronic conditions. Ninety percent of them are brought on by, exacerbated by lifestyle, and particularly what we’re eating, what we’re choosing to eat and choosing not to eat, and how we’re moving or not moving throughout the day. So, it’s really critical. And health coaches are needed now more than ever. And you also became National Board-certified. There is some concern that so many people are out there, anyone can hang up a shingle and say, “Oh, I’m a health coach.” And that is why the board was developed, to make sure that people met those minimum standards. So, what would you say to people who are thinking, “Well, I don’t know if I really need to be certified,” or how has being a board-certified health coach helped you in terms of your career?

Karen: I think 100%, if you’re going to hire a health coach, hire a National Board-certified health coach. They must meet certain criteria and trained in motivational interviewing. They have to have a certain amount of supervised coaching hours. At the Andrew Weil Center, we had to have 100 supervised coaching hours; the board requires 50. So, it’s rigorous training. It’s understanding some of the biomarkers that are needed to help refer clients to a physician, or a nurse, or a mental health… You learn really what’s in your scope of practice and what isn’t. And it’s really important to get the training in motivational interviewing and coaching, and really learning how to partner with your client, where the client is at the center of his or her own care.

Dr. Sandi: That is critical. And so many people think what a coach does is tell me what to eat, tell me how to exercise, and it’s not at all. It is helping people get that aha moment where that self-efficacy like, yes, I can control my health. And that is facilitating that conversation and deep listening.

Karen: It is. It’s exactly not a directive—where a physician is a directive approach, “This is what I want you to do.” And the health coach is, “Well, I’m going to help you learn how to do that. This is what you want to do; let’s come up with some ways to help you learn how to do that,” by evoking from within those aha moments, like what really inspires you, what is it that you want for yourself.

Dr. Sandi: That’s what makes it so powerful. And that conversation or that encounter that a coach has with clients, when you are engaging in that client-centered process, it’s so fulfilling for the coach as well. We do a survey of our graduates, and this career brings them joy. This is because with each encounter they grow as a person. And have you found that in terms of your work? And you’ve been working with clients a long time.

Karen: I feel like I learn from every single one of my clients. I learn from their joys, I learn from their setbacks, I learn from their successes, and we learn together. And it’s really very fulfilling for me.

Dr. Sandi: I found that, when I was a health psychologist, I was doing coaching in the ’80s and I didn’t really have a name for it yet, but that was the process because coaching comes from this Rogerian, Gestalt, client-centered type of therapy. So, so rewarding where you’re not the expert telling people what to do or what’s wrong with them but helping them fill an hour. So, can you talk about why we need to have health coaches as part of health care teams?

Karen: So many of us know what we need to do but we get in our own way and we don’t know how to do it. A health coach will give you the time, will really listen to what’s most important to you. What’s most important to you in your life? How do you want to show up? Why do you want your health? What does healthy living look like to you? And then we can talk about where some of these lifestyle areas—like your exercise, your sleep, your stress, your environment, your nutrition—how satisfied are you in each of these areas? And then we can choose an area to start, and we go one pillar after the next through our health coaching program until the client feels really satisfied and empowered to live the life that they desire.

Dr. Sandi: And that is uniquely said. And the process works so well. We have study after study showing that sometimes we have people saying, “Well…” A doctor… I led a panel, and we were answering these questions, like, “I can’t afford to hire a health coach.” What would you say to doctors, whether they be more conventional in their approach or integrative functional medicine, how is that health coach going to help them having them on their team, their patients, and themselves?

Karen: I think that a health coach could help these clinicians immensely because they can be in the session with the physician, and when the physician makes these recommendations, the health coach is taking the notes and the health coach can follow up with these recommendations, “So, Dr. So-And-So mentioned you need to do this and this. How’s that going? What’s getting in your way? What’s preventing you? What are your goals? How might this work for you?”

The health coach is going to help the physician be much more successful with his patients because patient compliance is difficult. When you have a limited amount of time with your patients and you’re directing them for X, Y, and Z—lose 30 pounds, maybe get off some of these metabolic syndrome medications, do this and maybe we can reduce your statins, do this and maybe we can have that—then the patient leaves and says, “Okay, well, I have to lose 30 pounds. How am I going to do that? Because it’s overwhelming. Where do I start?”

And having a health coach is going to help you create small changes. And over the period of like three months, six months, you’re living a completely different life and you don’t even realize it because you’re making such small changes in your behavior. We’re helping people create behavior change, and it takes time. And it’s small. And you’ve got to acknowledge yourself every time you make a small change. Let’s focus on the positive.

So many times I’ll follow up in a session with a client and I’ll say, “So, how did it go? What’s new?” And I try to start with what’s new and good because inevitably they start with, “Oh, I didn’t get to work out this week.” But then I learn, “Oh, but I’m drinking eight glasses of water a day. I’ve been adding in more leafy greens.” But they don’t start with that; they start with, “I didn’t get to exercise this week.” So, it’s really interesting helping them shift their mindset to more positive and acknowledge all their successes.

Dr. Sandi: That’s such an important point. It’s critical for the success of working with a coach. And what you’re really doing is you’re guiding them to change how they think and interpret events. And that process actually comes from cognitive behavioral therapy and positive psychology and you’re helping people to have a different perspective. And as my friend Joe Polish likes to say, “You can’t read the label when you’re inside the jar.” And so that’s where the health coach is going to help you read the label—have that perspective that you might yourself not be thinking. You might be feeling demoralized: “Oh, I didn’t meet my exercise goals this week.” But with that conversation, now they have a different way of thinking, and that’s going to change everything even… It goes down to an anti-inflammatory response that they’re creating when they think differently.

Karen: It does. And the health coach also can assess where they are in their ability to change. And so they usually start with a pre-contemplation stage, and then they go to contemplation. And you have to assess where are you in your ability and your desire to make some of these changes. And you have to be patient. And so we have to meet the client where they’re at. Every client is different, and every conversation and every program is going to be very different.

Dr. Sandi: Yeah, absolutely. And one of the things that I love about health coaching is that people can find that they’re very honest with their coach because they see you as more of their peer, as opposed to that authority figure, the doctor. And we know people are underreporting crazy in terms of symptoms, or they might not be taking their meds, or their supplements, or the program, and they’re not really honest with their practitioner. But they’re honest with the coach, and the coach has that range of communication. I wonder if you’ve found that as well.

Karen: I have because we create a safe environment without judgment. So, everything’s okay, everything’s good. And you’re afraid to tell your doctor, “Well, I haven’t really been following your direction,” right? But with us, they can say, “This is where I’m at. This is where I’m struggling. I’m having a hard time with this.” And we can love them up and accept them just the way they are, and then talk about, “Well, what would be the one next step for you that you might want to take? What are you thinking about?”

Dr. Sandi: Absolutely. So, you have chosen to specialize in working with a very challenging population, with a challenging condition: Alzheimer’s disease, early-stage cognitive decline. And you have studied ReCODE 2.0. And we at FMCA have also been very involved with that program. Tell us what influenced you to go, because you love learning. You’ve had a lot of dreams. I love that about you. And what inspired you to go further and learn the ReCODE? What is ReCODE 2.0? What’s the Bredesen Protocol?

Karen: Yes, I did complete the FMCA ReCODE 1.0, and then on to Dr. Bredesen’s 2.0 Apollo Health. What really inspired me was my father, who passed away from complications of Alzheimer’s disease. And I met Dr. Bredesen at a nutrition conference at the Andrew Weil Center for Integrative Medicine, one of our annual conferences, and he spoke about his prevention and reversal program of cognitive decline and Alzheimer’s disease. And I was just so intrigued. And I thought to myself, “Huh, having a father who passed from Alzheimer’s disease, maybe I can work with Dr. Bredesen as my practitioner.”

And he wasn’t really seeing new patients at the time, and so I decided, “I’m just going to become a practitioner.” And so I did. And I love his protocol. I love him as a human being, physician, and researcher. And he just wants to help patients become successful. He wants to help optimize patient outcomes. And this is the doctor who spends time with his patients. This is the doctor who spends time with his practitioners, with his health coaches. I’m on a call with him once a month with other health coaches, and we each present case studies. Actually, I’m presenting tonight. And it’s just so rewarding to help people prevent and reverse some of their cognitive decline, because there’s no known cure right now for Alzheimer’s disease. There’s a few monotherapies, but, you know, Dr. Bredesen says there are so many contributing factors to cognitive decline, and we have to look at each one of those. He calls them “holes in your roof.”

And so he has a program where the patient signs on with Apollo Health, and they send you your lab draw, an intake form, a really comprehensive health history. Your partner fills out or caregiver fills out a form. You take some cognoscopy tests, and this 58-page ReCODE report or PreCODE, which is the prevention report, spits out, goes to the client, and the client looks at it in complete overwhelm, “What do I do with this? Where do I start?” And that’s where the coaching comes into play.

And I help the Apollo Health patients, clients, do the Bredesen Protocol. And we had some really good… We’ve had a lot of good successes, and I’m so proud of my clients. And they are hard workers, and it is not an easy protocol with the diet, low sugar, environmental toxins you have to look at, your oral health, your sleep, your stress, your exercise. And it’s very fulfilling for me. And so most of my clients now are the Bredesen clients. I still have some weight loss and lifestyle clients, and I help families create healthy lifestyle habits for them and for their kids. But mainly, I’m focusing on brain health right now. Yeah.

Dr. Sandi: Yeah, well, this is such rewarding work, and kudos to you for studying the protocol. I love Dr. Bredesen. I had him on the podcast, and I was talking to somebody who is also doing the same thing you are, in terms of becoming… Ahe’s a ReCODE coach. And she was saying she goes out in the community and does talks in retirement centers, and finally people are so hungry for this. I wonder if that’s your experience, because in the mainstream, this is not well known, or if it is, it’s like, “Oh, it’s this false hope.”

Karen: Well, it’s not false hope because there’s not a lot of hope right now with traditional medications for cognitive decline. And we do know that certain biomarkers impact brain health. And so if we can get those biomarkers in that optimal range, they can really do well. And my clients are doing great, and they’re so motivated and inspired. It makes it easy for me.

Dr. Sandi: Yeah, and you are also helping their partners, their spouses, and caregivers as well. This is something that’s not… They’re not in isolation. And often it’s the caregiver who might play a big role.

Karen: Yeah, it’s often the three of us on Zoom. Absolutely.

Dr. Sandi: It is wonderful. So, you also have done a lot of things in terms of philanthropy and giving back to the community. Can you talk about what that’s like and as a health coach serving on a board at an integrative medicine center, a big hospital affiliated, the Osher, which I know quite well, and just in terms of what that’s like for you? And any interest you have seen and any changes you’ve seen over the years in terms of a growing interest in health coaching?

Karen: Definitely, my life’s mission is to help people live the lives that they desire, that they deserve through healthy lifestyle habits, because I live this lifestyle. I know it and I feel so grateful and so fortunate today to have good health that I can share these gifts. And the way medicine is practiced currently isn’t working, and so my passion for integrative medicine—following Dr. Andrew Weil, who was my mentor; my friend, Dr. Melinda Ring, at the Osher Center for Integrative Medicine at Northwestern Medicine… I serve on their advisory council. I’ve served since day one, chaired most of our benefits, and it’s my passion to help promote and teach people about integrative medicine and lifestyle medicine.

And I’m just so proud that I’m able to do this and to help people. And I think, because it’s my passion, people see that it’s my passion, and I think it becomes a little bit contagious because they see how passionate I am and how much I love this. And it’s like, “Okay, well, I want what she’s drinking because she seems to be able to love it and do it.” I’m not on a diet. This is a lifestyle. I eat plenty of sugar, and I enjoy myself. This isn’t about just discipline. It’s about really thinking about what’s most important to you and what you eat, how you feel and treat, and giving yourself the quality of all of these things.

I also serve on EWG (the Environmental Working Group). I’ve been on their board of directors for probably close to 10 years now. And another passion of mine is environmental health because environmental toxins and environmental chemicals are huge contributors to some of these chronic diseases like metabolic syndrome, for sure, Alzheimer’s disease, Parkinson’s disease, neurological conditions, and endocrine-disrupting chemicals. And so I try to educate my clients and the community about how to reduce their toxic load. And it’s really by making, again, small steps. You can make some small changes that aren’t going to cost extra money, that will really open up big doors for yourself to help reduce your toxic body burden, and you feel better.

Dr. Sandi: I am so glad that you brought that up—that you serve on EWG’s board. We refer to that group all the time for sources of information. And I think many people think of health coaching as this, “Oh, talking about food and exercise, for example, maybe sleep or so,” but not so much about the role in helping people with environmental toxins. And to see what we can get rid of, how we can stay as healthy as possible, how we can eat the kinds of foods that are going to support our detox protocols, for example, as well as how to live in the real world, which you also mentioned because you can be paralyzed with anxiety but really create awareness. I’ve recently become increasingly aware of the activewear that there’s forever chemicals and my favorite brands. I’ve been wearing this. It’s my uniform for years. And now I’ve been on a mission to find other brands that are pretty good with organic cotton. But those are some things people might not be aware of, and it’s where a health coach can play a huge role in increasing awareness.

Karen: It is. Like you said, our mattresses, our clothing, our air quality. People don’t even realize about doing a proper duct cleaning in their homes. And yeah, the food. The EWG’s Dirty Dozen and Clean Fifteen is a really great resource. What you’re cleaning your house with, the personal care products you’re putting on, ditching some of these fragrances that have phthalates. And those are known endocrine-disrupting chemicals and people just don’t know. And so if I can help educate them, they can make smarter choices, and they can use EWG for a free resource.

Dr. Sandi: So, you also started your own food company. I’d love to hear about that. Talk about Karen’s Homemade Health.

Karen: Okay, thank you. Yeah. So, my office is in Glencoe, Illinois, and I used to see my clients in person mostly. But since I’ve started with the Bredesen Protocol, I’m doing a lot of Zoom because my clients are all over the country. But I would make my clients my healthy homemade snacks. So, I had cranberry oat bars, or my power balls, or my coconut truffles, and grain-free brownies. And I would make them snacks, and constantly they would say, “Well, can I buy these from you, or how can I take these to the office?” And so I decided to create a packaged product that’s called The Protein Bar, and it’s just made with dates, almond butter, cacao, and some whey protein. And then I have a matcha bar that I created with Dr. Andrew Weil, using his matcha, and some almond butter, and again some dates, and some big chunky cacao chunks. And then I also have a line of vegan protein powders—vanilla and chocolate—and those are all third-party tested and super clean.

Dr. Sandi: Wow, that is awesome. So, is a cookbook in the works?

Karen: Probably not. But there is a book in the works. I can share more later. I’m just thinking about it now, but it’s really about how to create healthy habits.

Dr. Sandi: That is wonderful. You are such a spokesperson for health coaches because we really need to be out there. And I am so passionate about encouraging health coaches to spread the word, to tell everybody about what they do and how powerful it is. Share stories, share your personal story, because I firmly believe that we need a health coach on every primary care team, or every primary care team should have a coach in their community that they can refer to, that can then help their patients thrive in the best way possible.

Karen: We do. And it will really help the primary care providers to have a health coach on their team. I mean, it’s just going to make their job so much easier, and it’s going to make their patients so much more successful, and healthier, and happier.

Dr. Sandi: Yes. Yeah, this will truly transform healthcare. And you have been in this field from the beginning, and it has just been a delight to talk with you. So, where can people find you, and where can they find your products?

Karen: They can find me at karenmalkin.com. My products are on Amazon and they’re also on my website, the shop page for karenmalkin.com.

Dr. Sandi: Awesome. Well, thank you for being our guest today. This has been an incredible conversation. You are so inspiring.

Karen: Thanks for having me. You are too, Sandi. So, thank you for this movement. And your book is amazing. I just love all the research and just appreciate it, and I will be sharing it with many primary care providers.

Dr. Sandi: Thank you. Well, it means a lot.

Karen: Thank you.

Dr. Sandi: We need to spread the word. Thank you.

Karen: Take care.