Winter has come early to Tampere and a freezing mist of particles is slowly settling upon the inch or so of snow already underfoot. Despite being told to expect temperatures of -13C, I'm ill-prepared, a fact immediate to all who watch me stomp by, arms clapping about my body in protest.

If Tuomo and Leo are sympathetic, they don't show it. Both in their 60s, the two men are perfectly kitted out for such extremes and are making final preparations before heading off for maybe 20km of cross-country skiing around the city's park. The course loops and dips between frosted trees and, from the start, there are dozens of brightly coloured figures out there plodding through the snow during their lunchtimes.

There is nothing particular about Tampere that brings the skiers here or, for that matter, the cyclists, pedestrians and nordic walkers who pick their way along the paths and pavements, skiers robbed of their skis. Apart from a preponderance of red brick and factories that earned it the guidebook moniker, "the Manchester of Finland", Tampere is typical, the country's third largest city, wedged between two lakes and a two-hour train ride north of Helsinki.

If Tampere is typical for Finland, Finland is anything but typical of the world. According to sports and health experts, it is one of only two countries to have halted the downward spiral towards terminal couch potatoism, or sedentary inactivity to use the official parlance. Only Canada, though New Zealand may be a contender, can claim to have done as much to get people off their sofas and exercising.

Tuomo and Leo are ready for the off and cast an eye down the gentle slope and across the rest of the course. In the distance, a group of six or more figures is struggling up a lengthy incline but they eventually reach the top before plodding around as one and skiing back down like a human rollercoaster. "It's a good feeling. It keeps me in shape so I can do the things I want to do, "says Tuomo, adding there is no point coming to the park to do less than 10km. "We come here with our wives, "adds Leo. "It's one of the few things we can do together. What else would we do with them?"

Finland's success story is all the more impressive for where it has pulled itself up from. "In the 1970s, we held the world record for heart disease, "says Pekka Puska, director of the National Institute of Public Health in Helsinki. The dubious honour was the inevitable consequence of a Finnish culture that embraced just about every risk factor for heart disease there is. "The idea then was that a good life was a sedentary life. Everybody was smoking and eating a lot of fat. Finnish men used to say vegetables were for rabbits, not real men, so people simply did not eat vegetables. The staples were butter on bread, full-fat milk and fatty meat, "he says.

Present-day Finland is a very different place. Topping the league of death shocked the government into a full-blown campaign to dramatically improve peoples'health. And it seems to have worked. The number of men dying from cardiovascular heart disease has dropped by at least 65%, with deaths from lung cancer being slashed by a similar margin. Physical activity has risen and now, Finnish men can expect to live seven years longer and women six years longer than before measures were brought in. Having come so far, Finland now finds itself in the spotlight from health officials across the world who are desperate to find out what it was the Finns got so right.

The story begins in the sparsely populated frontier region of North Karelia in eastern Finland. The only part of the entire province to remain Finnish after the Soviet occupation in the Second World War, North Karelia was the least healthy region of a desperately sick country. In 1972, it became the focus of what was to become the country's path to recovery.

"The biggest innovation was massive community-based intervention. We tried to change entire communities, "says Puska. Instead of a mass campaign telling people what not to do, officials blitzed the population with positive incentives. Villages held "quit and win"competitions for smokers, where those who didn't spark up for a month won prizes. Entire towns were set against each other in cholesterol-cutting showdowns. "We would go in, measure everyone's cholesterol, then go back two months later, "says Puska. The towns that cut cholesterol the most would win a collective prize. "We didn't tell people how to cut cholesterol, they knew that. It wasn't education they needed, it was motivation. They needed to do it for themselves. "

Local competitions were combined with sweeping nationwide changes in legislation. All forms of tobacco advertising were banned outright. Farmers were all but forced to produce low-fat milk or grow a new variety of oilseed rape bred just for the region that would make domestic vegetable oil widely available for the first time. Previously, farmers had been paid for meat and dairy on the basis of the product's fat content. The changes recognised the flaw and linked payment instead to how much protein the produce contained.

Often, moves were attacked for being unpatriotic. Finland was a dairy-rich country and marginalising dairy farmers was viewed with disdain by many. But there were ways around the protests. When officials said the population must start eating fruit, protests poured in that fruit would have to be imported. To placate the farmers, the scheme was revised to encourage the growing of berries that thrive in a Baltic climate. Now Finland has a healthy industry producing all manner of berries, from redcurrants to blackberries.

In time, the Finnish authorities succeeded in forcing down salt intake, a crucial move for cutting blood pressure, and blood cholesterol has fallen along with fat intake and smoking. In 1972, more than half the middle-aged men of North Karelia smoked. Now around 30%do and the country boasts one of the lowest smoking rates in the world, despite having not yet fully imposed its stringent anti-smoking laws.

The early push in North Karelia was largely successful in weaning the population away from its staple diet of fat and fags, but there remained the problem of inactivity. As the measures trialled in North Karelia were duplicated across the country, a new effort to get people moving was kick-started. After diet and smoking, physical activity is arguably the most important contributor to health, with inactive people more likely to suffer from heart disease and various cancers, and have higher risks of developing diabetes and hypertension.

What is striking about the Finnish scheme to get people more physically active is the depth and breadth of its reach and the duration for which it has been sustained. It also hit the right tack from the off, first by selling enjoyable activities to people that happened to require physical activity, and second ensuring exercise was the cheap and easy choice to make.

From the start, the Finnish plans benefited by shifting money away from Helsinki to local authorities and making them responsible for exercise promotion. Obvious outcomes were cheap, clean swimming pools, ball parks, and well-maintained snow parks such as the one in Tampere. But less obvious were what medics might refer to as "unusual interventions ".

"There were towns where the pubs were full of middle-aged men who seemed to do little other than drink, "says Ilkka Vuori, a fitness expert at Tampere University and ex-director of the UKK Institute Centre for Health Promotion in Tampere. "They were a difficult group to reach, so teams went to the pubs, spoke to them and negotiated what they might be interested in doing as exercise. "Nearly 2, 000 men in one region were either lent bikes and taken on tours, tempted into a swimming pool, or had a shot at ball games or cross-country skiing. "It was about getting ideas that would work at that kind of local level, "says Vuori. "Success relied upon it. "

The closest thing to a British equivalent was tried out two years ago. Dubbed "Fat men in pubs " by Len Almond, the founding director of the National Centre for Physical Activity and Health at Loughborough University, the scheme was less ambitious than its Finnish counterpart - merely designed to find out what kinds of exercise middle-aged drinking men might consider. "We got them together and promised them beer the whole time they talked. They were very frank. Every one of them thought exercise was fine. Fine for everyone else that is, "says Almond. "There was absolutely no chance of even getting them to use their cars less and walk more. "

In Finland, the persistent renewal and creation of schemes has ensured that fitness remains in the public consciousness and that any gains in fitness do not slide away once the ball is back in the shed or the skis hung up for the season. Recently, "Young Finland " was set up to get even the most unsporting kids into sport. "What we saw happening was that the weakest, the least skilled and the most overweight were the ones dropping out of sports early and they are precisely the ones who need it most, "says Vuori. To tackle the problem, the scheme sought to dampen the competitive nature of sports. Goals went uncounted, victories uncelebrated and winning teams unpromoted. Though it may take some of the dread out of games afternoon for some, it's a strategy that hasn't been met with universal support. "Some people doubt how far we can take that, but it functions on some scale at least, "says Vuori.

Over the past 10 years or so, hundreds of local schemes have been set up across Finland, drawing previously inactive people into cycling, Nordic walking, cross-country skiing and ball games, all of which were either free or substantially subsidised to ensure no one was excluded.

But while one branch of the effort focused on getting people to exercise in their leisure time, another sought ways of weaving more exercise into people's daily routines - a kind of exercise by stealth. In a time when people often give the excuse of not having enough time to exercise, it was seen as the only way of reaching some groups. Commuting became an obvious target, and campaigns were set up to encourage people to walk and cycle more. The public health messages being sent out were backed up by action on the ground with hundreds of kilometres of new walking and cycle paths laid down to form networks into towns and cities, and money was provided to keep them well maintained and lit at night.

Persuading people to walk and cycle more can be a delicate decision in a country such as Finland where, for more than a few months of the year, temperatures can plunge enough to make the ground icy. "It's a tremendous problem for older people, because they won't go out if they're going to find it too slippery, "says Vuori. But it's a problem that is being dealt with. A revision to state legislation meant that in many places, the houses lining a street now take responsibility for keeping the pavements in front of their homes safe and clear of snow and ice. It doesn't sound like a law many would adhere to, but Vuori says it is taken very seriously. "If they don't do it, they're fined, and if someone falls, they can sue, " he says. "It seems like quite a small thing, but these kinds of measures make a big difference. "

To cut the chances of people coming a cropper all for the sake of a brisk walk, the government encouraged shoe companies to come up with non-slip soles. As if that weren't enough to hope for, in many cities elderly people can claim free sets of spikes to clamp to their shoes. "The hope is it stops them falling so much because they can easily break their hips, "says Vuori.

The latest practical measure being brought in is the Movement Prescription Project. Based on an idea cooked up in New Zealand, it encourages GPs to prescribe physical activity to their patients along the same lines as medication. Preliminary outcomes suggest that on the advice of a GP, the elderly especially benefited, becoming five to six times more active.

Observers of the Finnish success story are now working on how they can bring such drastic improvements to their own countries. Privately, some claim that Finland had it easier than many because its citizens are happy to live in a nanny state. Vuori believes nanny state is too strong a term, but concedes that Finland had advantages other countries might not. "There may be a greater proportion of people in Britain who believe it is not for the state to say what we can drink and eat, or whether we can smoke. In Finland, regardless of your political views, we are quite obedient, we are trustful of the state and the media. But people are also well-educated, they hear the messages we put out and they know they are sensible, "says Vuori.

Among exercise experts in Britain, there is a widespread acknowledgment that, regardless of how the Finnish people view their officials, what was done there worked beyond what many could hope for. "They were in it for the long term, they sustained promotion to make physical activity important and keep it important. They capitalised on their strength, which was a love of outdoor sports, and gave out grants for local-level projects. That's what happened there and frankly, it hasn't happened anywhere else, " says Fiona Bull, co-director of the National Centre for Physical Activity and Health.

Other countries have adapted the Finnish strategy to their own cultures in an attempt to emulate their success. In Brazil, communities have been promoting activities based around dancing. The challenge in Britain is identifying the activity that people love to do. "The problem is we're from an era where we've been locked into the idea of doing specific activities at set places and at certain times, "says Bull. "It's hard to describe a sporting scenario that appeals to the mass population. People think,'Gyms are full of sweaty men and skinny women ... Swim-ming pools are manky ... I could cycle, , but some cycle paths are awful ...' We need to tap into making activity accessible, fun and sociable. "

Len Almond says the government should bring together disparate interest groups, including the Countryside Agency, that promotes walking, and Sustrans, that encourages cycling, to develop a nationwide, but locally focused strategy to encourage more physical activity. Next year, rural communities may get to hear of "green movement ", a scheme designed to encourage gardening and conservation work as a form of exercise. "When you can get people to realise that a whole variety of things are forms of exercise, we might be able to get them to do more of it, "says Almond.

Though Finland is widely held up as an example of how to get it right, it is by no means a land of utopian fitness where managers high five their employees on the morning jog and no one zones out in front of the TV for hours on end munching pizza. With the big improvements taken care of, Finland is now facing new challenges. A huge influx of cars in the 1980s means fewer people now walk or cycle to work. An upturn in obesity is nothing compared to that Britain is experiencing, but significant nonetheless. And data from the army - national service is compulsory - show that fitness on entry, , as measured by a running exercise, has dropped steadily since the 1970s.

Mikael Fogelholm, director of the UKK Institute in Tampere, says that surveys show some 40%of men and 35%of women in Finland are still not active enough. "It's good that 60%are doing well, but we could still do much better. Total physical inactivity is a big risk for health, " he says. What is adequate depends on what you are doing. Fogelholm recommends active exercise - essentially sport or gym work every other day - amounting to two to three hours a week, , or daily "lifestyle activity", including walking to work or to the shops, gardening or vigorous cleaning for three to four hours a week.

"People always talk about not having enough time. I think that's rubbish. If life is so busy you really can't squeeze in a brisk walk, your life is a mess, "says Fogelholm. "If people took the amount of time they spent watching TV on one day and made it their whole week's exercise, we'd have no problem. "

With the publication last November of the government's public health white paper, Britain is now, albeit some decades after Finland, poised to make a concerted effort to improve physical fitness. The problem for everyone concerned is that improvements in transport, the rise of sedentary jobs, and developments in technology all conspire to make life less active. Persuading us to use our bodies more when we don't need to is strongly against the flow of change.

"The challenge we have is how do we get to the point where the question is why aren't you doing exercise rather than the opposite, "says Almond.

How the rest of the world is getting fit

The only way to get a nation of couch potatoes fit is to kick-start projects to attack the problem from different angles, says Tim Armstrong at the World Health Organisation. At a government level, that means involving not just the health and sports departments, but town planners and those running the transport networks too. "It's no good just telling people to be physically active, " he says. .

In the Colombian capital of Bogotá, profits from a publicly owned electricity company were used to clean up the streets and build new cycleways. "Masses of people came out to use them and it actually made the place much safer too, " says Armstrong. .

In Sweden, various schemes to get people cycling have been started up. In Helsingborg, locals received free pocket-sized maps of cycle routes, while in Gothenburg, a grander scheme set teams of up to 40 people from local companies the target of cycling 30 times in five months, with each trip being more than 2km. Each team member received a free waterproof poncho and those teams that succeeded went through to a prize draw. The prize?A cruise to Newcastle.

The Netherlands and Belgium have set up pro- cycling schemes for the elderly after studies showed that not only were they the most likely to be knocked off in the road, but that they often gave up cycling because the traffic was too dense. Participants were sent on an assertive cycling course which gave tips on how to set off on a bike, how to stop suddenly and how to cycle one-handed.

The bike push has also geared up in the UK where the group Sustrans has been educating school children about the benefits of cycling after a National Travel Survey showed that more than a third of primary school children and more than a fifth of secondary school children were driven to school. Survey results suggest cycling went up by more than 50%in some schools where the scheme was piloted.

Many countries have focused on promoting walking. In Udine, Italy, parent-teacher groups have got together to research the safest routes to walk to school. In Israel, a much larger push to get people walking was set up with the recruitment throughout the country of volunteers over 60 years old who liked walking. The volunteers then led walking groups around local neighbourhoods. To make sure they were noticed - 40% of pedestrians hit on Israeli roads are elderly - each walker was issued with a hat and reflectors.

Meanwhile, in the Finnish town of Jyväskylä, local authorities were concerned that the elderly were staying in, especially during winter, because it was dark and the pavements were slippery. To make it easier for them to exercise, they persuaded the bus companies to stop by day centres and old peoples' homes and then at the local swimming pool. With the swimming pool paying for the bus fares, pensioners were brought in from 17 suburban regions, mostly for aqua-aerobics.