When a woman notices her jeans fit a little too snug around the waist, she knows its probably time to hit the gym.


For a menopausal or post-menopausal woman, acting on this realization could save her life.


A study last year by the Seattle-based Fred Hutchinson Cancer Research Center found that extra fat in and around the abdominal area can promote growth of cancer cells in women. Other studies have shown that this intra-abdominal fat can cause greater risk of dangerous chronic illnesses such as diabetes and heart disease for both women and men, says Dr. Judy Marvin, an obstetrician and gynecologist at Northwest OB-GYN PS here.


The Fred Hutchinson study showed that post-menopausal women who participated in regular, moderate-intensity exercise reduced their weight, including total body fat and intra-abdominal fat, decreasing their risk for chronic illnesses.


Marvin says exercise has helped many of her patients to lose the abdominal fat that can cause medical problems.


Ive seen people who were able to eliminate diabetes by exercising and lowering their weight, she says. They feel so much better about themselves and eat better diets when exercising.


Older women tend to store more of this fat, which gathers around the stomach, colon, and other abdominal organs, because as they age, their fat accumulates more in the central areas of the body than in the extremities, Marvin says.


Some women gain abdominal fat steadily as they get older and their metabolism slows down, while others gain significant amounts of weight abruptly, Marvin says. Doctors arent sure why such sudden weight gains occur, other than when a woman has changed her lifestyle in some way, she says.


Doctors refer to someone who tends to gain more fat around the abdominal area as an apple-shaped person, while someone who has more fat around the hips and thighs is called a pear-shaped person, Marvin says. While some people may fall in a gray area, apple-shaped people typically are considered to have greater risk of contracting chronic diseases than pear-shaped people.


Abdominal fat creates greater risk for diabetes because it is insulin-resistant, which means the body cant use naturally-produced insulin as well as it should to regulate blood glucose levels, Marvin says.


Exercise helps counteract this detrimental effect by increasing the bodys sensitivity to insulin and helping make insulin work better, she says.


Dr. Elizabeth Grosen, a gynecological oncologist at Cancer Care Northwest PS, of Spokane, says most people dont realize that many kinds of malignancies are linked to obesity.


The risk for certain types of cancers, such as uterine, endometrial, and breast cancer, increases multifold in women who are obese, Grosen says. Since these cancers mostly are related to excess estrogen production, and estrogen is produced in fat cells, the more overweight a woman is, the greater cancer risk she has, she says.


Grosen says she has seen many female patients who are obese, but arent doing anything about it, even though cancer has been shown to occur more in women with higher body mass indexes. An example of the typical recurrent uterine cancer patient she sees is a woman who has high cholesterol and blood pressure, diabetes, and weighs 300 pounds, she says.


Patients are willing to come in and have you do things to them to affect their disease, but arent willing to take responsibility for their own health, she says.


While obesity causes negative effects for women, it also makes surgeries more difficult for physicians to perform, she says.


Grosen says she suggests that patients exercise and control their diets to reduce their body fat, and encourages them to avoid gaining too much weight in the first place.


Cancer Care Northwest, in conjunction with St. Lukes Rehabilitation Institute here, has started offering a breast-cancer patient rehabilitation program called I Thrive that includes fitness classes, Grosen says. The exercise helps breast-cancer patients reduce fatigue and gain less weight as they recover from cancer treatment, she says. I Thrive also offers nutritional advice and counseling.


Women need to pay attention to what happens to their bodies as they age, Grosen says.


Its important for women to be aware that theres two parts to the equationincreasing exercise and decreasing food intake, she says. Its really something Im trying to educate my patients about.


Stress on organs


Joyce Kratz Klatt, an exercise physiologist at Kootenai Medical Center, says women need to understand that if they have too much abdominal fat, it likely is spread throughout the central cavity, which puts more pressure on the heart and other organs.


The more fat you have, the more blood vessels you have, the more work your heart has to do to make the blood vessels work, she says. It all makes your heart have to work harder getting good circulation throughout the body.


Any physical activity that increases the bodys heart rate and uses large muscle masses such as the quadriceps and back will help lower risk for heart disease, Kratz Klatt says.


Walking at a moderate pace for 30 to 60 minutes can be as good at preserving cardiovascular health and maintaining weight as running for 20 minutes, she says. Exercising at a moderate level for an extended period of time helps burn more fat and increase aerobic capacity than performing more strenuous exercise for a shorter period, she says.


Swimming and bicycle workouts also can improve heart health, Kratz Klatt says. Though Pilates, yoga, and other aerobic activities can help maintain cardiovascular levels, women should pace themselves and be careful of exercises that could cause injury, she says.


Kratz Klatt supervises two programs at KMC, one called Womens HeartAdvantage, which offers women personalized health advice for improving their lifestyles, and another called Active for Life, which helps women and men with cardiopulmonary rehabilitation through exercise. At least two-thirds of the Active for Life class attendants are menopausal or post-menopausal women, she says.


Jean Hansen, a 71-year-old Hayden Lake resident who attends the Active for Life class, says that exercising regularly for the last 15 to 20 years has reduced the effects of her osteoarthritis. She says she thinks it also might have helped her avoid developing the heart conditions and asthma that run in her family.


It gives me a better frame of mind and helps me to move more freely, she says.


Kratz Klatt says there isnt a specific amount of weight that women need to lose to reduce their risks for chronic illnesses. Nonetheless, a woman should be able to sustain a moderate activity level for 20 to 60 minutes and simultaneously be able to carry on a normal conversation to maintain a healthy lifestyle.


Weight is just one gauge


Women shouldnt judge their fitness levels entirely on how much weight they carry, since exercise adds muscle mass, Kratz Klatt says. Instead, they should watch carefully how their pants fit at the waist, which will get smaller after exercise even if little weight is lost, she says.


Marvin says that women and men can be fit and obese, or overweight, at the same time. Fitness is more a measure of exercise tolerance than body composition.


Though someone can be physically fit and overweight, women should be aware of their body weight, Marvin says. A woman can tell if she has too much abdominal fat by measuring the area above the waist at the belly button. If her measurement is more than 40 inches, she may have an increased risk for some diseases, she says.


Aging women may need to exercise more to counteract the effects of their metabolism slowing down, Marvin says.


Your ability to exercise declines as you get older, she says.


Besides decreasing the risk of cancer, diabetes, and heart disease, exercise helps protect against osteoporosis by stimulating the body to make bones more dense, Marvin says.


Women also can cut their risks for many illnesses by sticking to diets with plant-based foods, whole grains, and fruit, combined with exercise, she says.


Kratz Klatt says women who are approaching menopause can change their lifestyle as they become aware of how their hormones will affect their bodies.


Theres a blind assumption that Im expected to gain weight as I get older, she says. Well, you dont have to.