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No doubt, summer arrives with its own rhythm, its own demands, and its own kind of freedom. Summer is an invitation to revitalize, rejuvenate, and redefine your fitness routine. As the mercury soars, the conventional gym walls might feel more like a prison cell than ever before. So, how about we shake things up a bit?

Let’s break away from the conventional and immerse ourselves in a summer fitness experience like no other. Brace yourself for an exhilarating journey to the best shape of your life.

Here are my 6 basic principles for proper summer fitness.

You can certainly train in the gym during summer. I do a lot of my training in the gym, indoors, throughout all seasons. But gym training isn’t unique to summer. Plus, it’s the default option for most people. I’m trying to get you to try something you haven’t tried before, to train in a way you can’t always train.

Sure, if it’s 100 degrees out, you might want to do the gym. You might want to get some shade. But summer affords you the opportunity to train outside in most locales.

Train barefoot in your background or a park. If you have gym equipment, simply take it outside and do what you normally do in the garage, only on the grass or dirt.

Train in the forest. Climb trees, lift logs, throw boulders.

Train at the beach or at the lake or river. Bring a kettlebell out there and get to work.

The key to great summer fitness? Making it not just about the sweat and effort, but about the sheer joy of movement, the exhilaration of performance. If you make training fun, you actually look forward to it. You enjoy it in the moment, not just when it’s over.

Seeking healthy pleasure is a cornerstone of being human and thriving as a human. Pleasure is how our brain reward systems get us to do things that are good for us. Exercise is no different.

And just because it’s fun doesn’t mean you’re not going to be working hard or getting a great training effect from it. It means the workout is intrinsically valuable in the moment, and therefore more sustainable.

The picture of this begins in your backyard, under the bright summer sun. In your hands, a kettlebell, that deceivingly simple yet incredibly effective piece of equipment. You swing it, lift it, press it, transforming each movement into an opportunity to build muscle, endurance, and strength. Each swing is met with a cool breeze, each lift underlined by the sun’s rays bestowing upon you a golden glow and a healthy dose of vitamin D.

Transition your training ground from your yard to the vast, blue expanse of a lake or an ocean. Envision yourself gracefully cruising on a stand-up paddle board, or perhaps navigating the waves in a kayak. It’s not just a workout; it’s an intimate connection with water, an element that has been entwined with our existence since evolutionary times. Comfort in water is a fitness staple, and summer is the ideal time to master it.

On dry land, there’s an entirely different adventure waiting for you. Picture yourself biking on winding trails or rollerblading down the coastline. Consider these not just as fitness tools, but as vessels of exploration. The goal isn’t merely to burn calories but to soak in the surroundings, to integrate with the elements, to experience the freedom that summer brings.

These tools— the humble kettlebell, your watercraft, and your chosen mode of land exploration— they are your partners in fitness, enabling you to tap into the unexplored power of outdoor training. What makes them special is that they aren’t just exercising equipment; they are a part of your summer fitness story, enhancing the quality of your workout and your overall experience.

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Instead of just using the rower at the gym, go kayaking down the river, through some sea caves, or across the lake (for time, if you wish to increase the intensity). Or, as I do, paddle down Miami canals, often meeting dolphins and manatees along the way.

Instead of only walking on the treadmill, do a backpacking trek for a day or two. Carry your belongings up and down mountains, over boulders, through meadows and across rivers. You’ll log far more steps than you ever would on the treadmill while getting an incredible sensory experience out of it.

The gym is great. I use it myself all the time, no matter the season. But the point is to take your conventional gym training and use it to conquer the world and go on adventures.

I’m not going to tell you what specific exercises to do. Deadlifts, squats, pull-ups, push-ups, presses, rows, swings, muscle ups, dips, lunges, step ups, hip thrusts… they’re all fantastic options. You know what you like to do. I am going to tell you to try being a bit more intuitive and “touchy feely” when you train. That’s what summer is: a season for intuition and feeling and spontaneity. Foster that summer spirit with your rep schemes.

Here’s what I mean.

Say you’re doing push-ups, kettlebell swings, pull-ups, and squats. Or dips, trap bar deadlifts, rows, and lunges. A push, a pull, a row, and a knee flexion.
Instead of hitting a set amount of reps, do the first exercise (push-ups) until you go just shy of failure. 2-3 reps left in the tank.

Move on to the next one (kettlebell swings) and do the same. Feel that deep burn but keep a few reps in the tank. When you’re ready, return to the first exercise and do the same. Then do the same for the next one.

When you’ve hit 3-4 sets of these, move on to the next two exercises and repeat the process.

You’re learning how to feel when you’ve approached your limit. You’re getting the training effect for your muscles but you’re also training your intuition. That’s summer.

Summer, for all its joys, brings with it an intense heat. But instead of letting it bog you down, let it fuel you. Embrace the warmth, revel in the sweat. Get filthy, dirty, dusty, muddy. Summer is your chance to build heat tolerance and improve your overall fitness level.

It’s also the time to use water to your advantage. Whether it’s plunging through the waves at the beach, diving into a crystal clear alpine lake, swimming with (or against) the current in a river, or even doing laps and underwater pool workouts, the water is an entirely new playground for your fitness exploits.

When the sun climbs the sky, don’t hide indoors. Go outside and train in the oldest, biggest gym in the world. Soak up as much sunlight as you can, safely—don’t get burned, of course. It isn’t just a pathway to a glowing tan, nor is it only a source of vitamin D, which is a crucial prohormone involved in muscle protein synthesis, bone density accrual, and hormonal health. It also increases nitric oxide production, which can improve the transmission of oxygen and important nutrients to your muscles and other tissues as well as enhance the “pump” you get when you lift weights.Furthermore, training in hot weather can add an additional stressor—the heat—that can enhance the training effect. However it is a stressor and you may need more recovery from an outdoor sun drenched workout, but you can also derive greater benefits.

Just make sure that you stay hydrated. Add high quality salt to your water or make an electrolyte mix. I like to add a packet of LMNT to water plus collagen and creatine, then sip that before and during my workout. Hydration will improve not just your workouts but also your skin’s resistance to UV light.

In essence, summer fitness is about embracing the inherent power of the season—the heat, sunlight, sand, water, and the calming energy of nature.

Summer fitness is an exploration, an adventure. The sun-soaked season invites you to push beyond the typical, to break free from monotony and create a summer fitness routine that reflects the unique opportunities of the season. The world is your gym. Now go out there, embrace the heat, the sun, the water, and make your summer fitness journey an unforgettable one.

How do you approach fitness in summer? What are your basic summer fitness principles?

Mark’s Daily Apple is still under construction. My team and I are actively working to repost the archives. Check back regularly to find posts that are new to you and revisit old favorites. Looking for a specific post? Let us know here.

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* This blog reflects my personal views and opinions and isn’t intended as medical advice, but I hope it will be informative and inspiring as you pursue a healthy, fulfilling life.

A Medicare Annual Wellness Visit (AWV) is a chance to connect one on one with your care team to get questions answered, review medications and create a personalized prevention plan for the year ahead. The goal of an AWV is to keep you healthy, spot risks early, and guide you toward the right preventive screenings and lifestyle choices.

AWVs are always 100% covered when you go to an in-network provider. Still, some people are surprised by a bill afterward. This usually happens when part of the visit goes beyond preventive care. Below, we explain why this can happen and how to avoid unexpected costs.

Why you might be charged after your Annual Wellness Visit

Per Centers for Medicare and Medicaid Services rules, an AWV covers preventive care only. If your visit ends up including diagnosing or treating a specific health concern, that part of the visit may be billed as a regular office visit. Some people choose to combine their AWV with other appointments, such as primary care or their annual physical. When this happens, the AWV portion is covered fully, but other services during the same visit may result in charges.

Knowing what is and isn’t considered preventive care can help you better understand your costs.

What’s considered preventive care

Preventive care services usually covered during an AWV include:

• Reviewing medical and family history
• Checking weight, height, temperature, blood pressure and pulse
• Test for cognitive wellness
• Preventive screenings and immunizations recommended for you by your doctor
• Reviewing current medications
• Talking about your overall health and lifestyle

What’s considered treatment care

These services aren’t considered preventive and may be billed separately:

• Discussing or treating a specific health concern, condition or injury
• Ordering or reviewing lab work, X‑rays or other tests to diagnose health concerns

An AWV example: When part of an AWV turns into a billed office visit

Anne comes in for her AWV. During that visit, her doctor checks her vitals, makes sure her current medications are still working effectively and recommends small lifestyle changes she can make to help her continue to feel her best. All of those topics are covered at no cost as part of her AWV.

However, during the visit, Anne also mentions she’s experiencing occasional shortness of breath. To address this, Anne’s doctor performs a physical exam to listen to her lungs, and orders an X-ray and lab work to diagnose what’s causing her shortness of breath. That portion of her visit results in Anne receiving a bill for her office visit copay.

How HealthPartners members can avoid unexpected charges during their Medicare AWVs

It’s important to talk openly with your doctor and ask questions. Don’t avoid topics because you’re worried about cost. Instead, make sure you understand what services are covered so there are no surprises later.

Before your visit, you can:

• Call Member Services with questions about billing, coverage or what counts as preventive care
• Confirm the appointment is scheduled as an AWV

During your visit, try to:

• Ask your doctor if a topic is covered under the AWV
• Ask, “Will this be billed separately?” if you’re concerned about the possibility of being billed
• Mention to your doctor that you only want to cover topics included in an AWV

After the visit, make sure to:

• Review your Explanation of Benefits (EOB)
• Contact Member Services if you have questions about charges

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Everybody feels their body change as they age, and it can be hard to tell what’s normal. In particular, if you’re a man feeling changes in your energy levels or libido as you get a little more gray in your whiskers, you might question whether your hormones are behaving normally. This might then lead you to wonder if men go through their own kind of menopause like women do.

The short answer? No. Menopause is a specific biological event that’s unique to women. But the phrase “male menopause” is sometimes used as a shorthand to describe what men really do experience: age-related changes in their hormones. We’ll go over what those changes look like below.

There’s no true “male menopause,” but men’s testosterone does decrease naturally

There are a few reasons why “male menopause” is a misleading term for what men experience. The first is that menopause refers to the end of a woman’s reproductive years – something that there’s no equivalent for in men.

The other reason is that the hormone changes women experience in the lead up to menopause are very different from the ones that men experience as they age. In the years leading up to menopause, women’s estrogen levels naturally begin to drop, but can fluctuate significantly even as they trend downward. This can lead to a range of menopause symptoms like mood swings, hot flashes and more.

By comparison, men’s testosterone levels generally decrease gradually, by an average of 1-2% per year starting around their mid-30s, although the start and rate of this decrease can be affected by certain health conditions, medications and other factors like physical fitness. And unlike menopause, which is a universal stage of life for women, doctors only attach a label to a man’s decreasing testosterone when it’s proven to be both:

• Lower than expected for his age
• Causing symptoms

In these cases, it may be referred to as testosterone deficiency, male hypogonadism, or late-onset hypogonadism (if it’s strictly the result of aging). You may also see people use the term “andropause” to describe age-related declines in testosterone.

What feels like symptoms of “male menopause” may be low testosterone or something else

Testosterone supports many aspects of men’s health, including muscle mass, energy and desire. So if your levels are especially low, it may very well be noticeable. That said, low testosterone doesn’t always cause symptoms.

Studies estimate that 40% of men over the age of 45 and 50% of men in their 80s have male hypogonadism. So while many men may experience low testosterone eventually, many others (including older men) don’t fit the criteria. Many symptoms of male hypogonadism can also be caused by other health conditions, which is why it’s important to talk with your doctor about what you’re experiencing.

Symptoms that most commonly indicate male hypogonadism include:

• Fewer spontaneous erections
• Hot flashes
• Increased tiredness or fatigue
• Low sperm count (resulting in infertility)
• Reduced armpit and pubic hair
• Reduced sexual desire (libido)

Other symptoms male hypogonadism can cause include:

• Depression
• Erectile dysfunction
• Loss of hair on body and face
• Increased body fat and reduced muscle
• Osteoporosis (low bone density)
• Sleep pattern disruptions
• Trouble concentrating

Men may not experience menopause, but that doesn’t mean nothing’s happening

If you’re experiencing symptoms that could be due to male hypogonadism or another health condition, talk with a doctor. A primary care doctor with expertise in men’s health can help rule out other possible causes and refer you to a sexual health specialist, urologist or endocrinologist if more tests are needed.

Many of the health factors that contribute to low testosterone can be reversed, and even if it turns out that age-related hormone changes aren’t the problem, your doctor can recommend lifestyle changes or other treatments that may help you feel better.

If you or your child is dealing with a sore throat – especially if the pain has lingered for a few days or home remedies don’t seem to be working – it may be time to see a doctor. But should you go to urgent care right away, make a primary care appointment or do something else?

The right choice often depends on how severe the sore throat is, other symptoms being experienced and which care options are available. Below, we walk through symptoms that may indicate a more serious infection behind a sore throat, and when to see a doctor at an urgent care or elsewhere.

Get in-person care for a sore throat that lingers or is paired with certain symptoms

Sore throats have a lot of possible causes. Most of the time, they’re caused by viral infections like the common cold or influenza, which typically improve over a few days with home remedies to relieve throat irritation, such as gargling with warm saltwater or over-the-counter pain relievers. But if a sore throat isn’t improving or is getting worse after a few days, it’s likely time to see a doctor.

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This is especially true for anyone who develops symptoms such as:

• Bad breath
• Blood in saliva or mucus
• Earache
• Fever higher than 100.4° F
• Joint pain
• Rash
• Red or white spots in the mouth
• Swelling or a lump in the neck or face
• Trouble opening the mouth or swallowing

These symptoms may be signs of bacterial infections like strep throat or a more serious viral infection like mononucleosis. Bacteria may also cause these symptoms by infecting certain parts of your mouth and throat, such as your tonsils, adenoids, epiglottis or uvula.

Choose urgent care for a sore throat if you need care now or primary care isn’t available

If you or your child have a sore throat that is very painful or has a high fever, swollen lymph nodes in the neck or a rash, go to urgent care. These symptoms can be more common in bacterial infections where antibiotics may be needed for treatment.

You should also go to urgent care if you can’t get a primary care appointment as quickly as you’d like or it’s outside of normal clinic hours, like on the weekends. At HealthPartners, you can check wait times at urgent care locations near you and use our Save My Spot feature to get in line to be seen before you even arrive. In fact, our patients can save up to 56 minutes in the waiting room by using Save My Spot.

How much it costs to treat a sore throat at urgent care depends on a few factors

The cost of an urgent care visit depends on where you go, your insurance coverage and what care you receive. At HealthPartners, an urgent care visit is billed the same as an office visit, but the exact cost will vary depending on the testing and other services provided.

Choose primary care for a sore throat if care can wait for the next available appointment

At HealthPartners, we often have same-day and next-day primary care appointments available.

Go to the emergency room if you have severe throat pain or trouble breathing

If you have symptoms that may be life-threatening or that are interfering with your ability to care for yourself, call 911 or go to an emergency room. Examples include:

• Severe throat pain
• Trouble breathing
• Sudden sore throat combined with a headache, dizziness, confusion or nausea

These may be signs of a serious infection or an acute issue like carbon monoxide poisoning.

Get the care your sore throat needs – urgent or otherwise

Whatever symptoms you’re experiencing, we’re here to help you get relief as quickly as possible. If a sore throat isn’t going away or your symptoms are getting worse, see if a same-day or next-day primary care appointment is available. If primary care isn’t an option or you need care sooner, head to urgent care. Either way, your care team can help determine the cause and what type of treatment you need.

The 80/20 principle has been a centerpiece of the Primal Blueprint approach and philosophy since the beginning, but I still get comments and questions about it. In case you’re not familiar:

The 80/20 principle suggests that in the context of a full and earnest commitment to making health-promoting choices, conforming with the ten Primal Blueprint Laws 80% of the time will yield a solidly healthy result.

Many tell me how much they love the concept. It’s a feature that makes the Primal lifestyle possible for them.

Others suggest that it leaves too much room for backsliding.

Still others find it confusing—does it mean living 100% Primal only 80% of the time and partying it up that other 20%? Or does it mean living 80% Primal 100% of the time? (The answer is neither, as you’ll see.)

I love having these kinds of discussions within the community. Your perspectives help me to continue to grow and evolve my thinking even after all these years. So let me share my perspective on the 80/20 principle, and I encourage you to share your own thoughts in the comments as well. Just because I’m “the Primal guy” doesn’t mean I get to dictate how you interpret what it means to live Primally, nor how you embody these teachings in your own life. It’s obviously a general principle and, as such, it’s intended to mean different things to different people.

In short, the 80/20 principle is designed make Primal doable in the context of the modern world. It’s a feature that makes the Primal Blueprint a fully achievable, enduring lifestyle that reconciles with the grind and disruptions of daily life.

Let me put it this way: the 80/20 principle is an acknowledgment that we’re adults who take full responsibility for every choice but occasionally find ourselves in circumstances that aren’t conducive to adhering fully to the Primal Laws.

You should always have the intention to do your best, to aim for 100%. But you should not let your commitment to Primal living become a source of stress or anxiety, and you shouldn’t beat yourself up or throw in the towel when perfection isn’t possible.

You have agency and reasoning skills, so you should be able to make conscious compromises. Perhaps you’re on vacation and really want the experience of sampling the local cuisine. For you, it’s part of the adventure. You authentically choose within the 80/20 principle to make the most of your hard earned adventure. (Personally, this is my favorite manifestation of the principle.) Maybe it’s a special anniversary or family gathering. You don’t use the situation as an excuse to wildly abandon your commitment to health and longevity. You loosen the strings enough to find the best balance between short-term experience and long-term goals.

Sometimes the 80/20 principle is a matter of feasibility. Travel doesn’t always present the most ideal Primal options. A difficult period in your life (new baby, death or serious illness in the family) may temporarily disrupt your focus or ability to do all the good things you normally incorporate into your routine.

There are also the Primal ideals, especially when it comes to food. I know not everyone has ready access to or the budget for grass-fed beef, pastured butter, organic produce, or a wide diversity of produce year round. This is where that old saying comes in: “Don’t let perfect be the enemy of good.” The majority of the health benefits from Primal come from eliminating the grains, sugars, and nasty oils. Worrying about organic, local, and so on is the cherry on top. Likewise, if all you manage right now is walking and microworkouts, but you haven’t found a way to build sprints into your routine yet, you’re still miles ahead of the person who is still sedentary.

Sometimes you just have to do the best you can. It’s not a question of motivation or commitment but the influence of external conditions. Think of it as a cushion, not a cop-out, and focus on the big picture. Primal success is less about what you do at any one meal or single bout at the gym and more about what you do over the course of a given week or month.

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Most importantly, it isn’t permission to only shoot for 80% compliance or success. If you set out to make your Primal commitment 80%, guess what. It will likely fall well below that. If you set out to make your commitment 100%, you’ll probably settle in somewhere between 80 and 95%.

It doesn’t mean getting 20% of your calories from ice cream and the other 80% from meats and salads. The 80/20 principle isn’t about “cheating” 20% of the time.

It isn’t intended as a “get-out-of-Primal-free card” for flocking to grains, skimping on fat or protein, or ignoring a continuing sleep deficit.

It doesn’t mean you’re perfect during the week and then go on a bender on the weekend.

It doesn’t mean working out 10 months of the year and then taking two months off to veg on the couch.

It doesn’t mean picking your favorite 8 of the 10 Primal Blueprint laws and scrapping the other two.

And let me be clear: there’s nothing wrong with achieving 100%. If you find the Primal Laws easy to incorporate fully into your life, that’s cause for celebration, not concern. I would never suggest that you’re missing out on life because you don’t feel the need to indulge in conscious compromises. More power to you if you’re happy and fulfilled without them.

Decidedly no, but I’ve gotten this question a fair amount, so let’s clear it up. When people talk about the 80/20 diet, they usually mean the eating strategy attributed to Australian nutritionist, chef, and personal trainer Teresa Cutter. In this approach, you are supposed to “be good” 80% of the time, but you are allowed to indulge the other 20% of the time within reason. No foods are off the table. It’s a “have your cake and eat it too” diet, and it’s very much NOT what the Primal 80/20 principle represents.

The Primal 80/20 principle isn’t a diet at all; it’s more of a mindset. It’s about giving yourself permission not to be perfect, not actually planning dietary excursions into your week. By the same token, the 80/20 principle isn’t carb cycling, alternate day fasting, or any other structured eating pattern. With those, the assumption is that you’re (mostly) sticking to Primal foods but eating at specific times or with certain macronutrient ratios.

And of course, the Primal Blueprint encompasses more than nutrition, so the Primal 80/20 principle does as well. All aspects of Primal living—movement, sleep, stress management, social connection, cognitive challenge—fall under the 80/20 umbrella. There are probably some aspects you’re closer to 100% on most of the time and others you struggle with. For me, the food part is easy, but I’ve historically struggled with the stress bit.

There are times when 100% compliance—or something close to it—is important. One example that comes to mind is when someone is using an elimination diet (autoimmune protocol, low-FODMAP, etc.) to explore chronic symptoms. Unless they are strict about eliminating and then systematically reintroducing potential trigger foods, the diet probably won’t be much use.

Another time when it makes sense to be stricter is during the transition to a keto diet. Ketosis is a notoriously fragile metabolic state. Eat a single high-carb meal or snack, and wham, you’re out. When you’re in the process of adapting to keto, it makes sense to be consistent for at least the first four to six weeks to facilitate the process. Even after that, there’s little wiggle room if staying in ketosis is important to you.

At its core, the 80/20 principle is a recognition that life isn’t totally predictable and that we’re not in Grok’s Kansas anymore. Denying that reality and trying to fit Primal principles perfectly into modern life can be like jamming a square peg into a round hole.

The point of 80/20 is to release the pressure valve that comes with thinking that you are supposed to be perfect and that this Primal living thing should come easily all the time.

As the Primal Blueprint cements itself in your routine, it generally becomes easier (and more desirable) to live well above that 80%. That was my experience, and I can’t even count how many people have told me the same over the years.  The Primal Blueprint comes naturally for me now because my entire lifestyle revolves around it and I’ve been doing it so long. It’s so much a part of my routine that I don’t often think about it except when I travel. It will become your normal as well, but the chance that you’ll always be the perfect Primal specimen are small. I’m not, and I’m fine with that.

I encourage everyone to focus on the process and the big picture, not simply the daily details. The Primal Blueprint is first and foremost about taking full responsibility for your life and health. No excuses, no guilt.

As always, thanks for reading, and keep the questions and comments coming!

Thank you for reading!

Mark’s Daily Apple is still under construction. My team and I are actively working to repost the archives. Check back regularly to find posts that are new to you and revisit old favorites. Looking for a specific post? Let us know here.

You can help more people find us by spreading the word:

Share Mark’s Daily Apple

And make sure you’re subscribed!

* This blog reflects my personal views and opinions and isn’t intended as medical advice, but I hope it will be informative and inspiring as you pursue a healthy, fulfilling life.