I have long relationships with some of my readers. One contacted me first with a challenging project -- teaching her cat to use a scratch post -- and moved on through a wedding at a shrine and later a divorce, and finally the establishment of her own business. We have never met but we are friends so when she wrote about her new career I was interested, especially since it was with a company whose name I knew well in other days when home was Indiana: Rexall Drug Store. Before megastores and discount outlets, Rexall had a reputation for reasonable prices and quality products. Now Rexall has become international and Rexall products, focused on health-care and diet supplements, are sold to customers by trained distributors through direct marketing -- a sales technique used by many companies that accounts for some $30 billion in annual sales in Japan. Her enthusiasm about Rexall products is well founded. She had worked for many years with cardiac surgery patients and reports that many former colleagues are using Rexall preventive health-care products with excellent results.

Direct sales is about the only way for such health-oriented products to go here in Japan, where regulations strictly limit claims that can be made for efficacy, and even explanations of what they might do are limited. Yet articles on health and nutrition in newspapers and other publications inform the public of new developments and of supplements that show promising results in treating such problems as hypertension, diabetes, vision disorders, anxiety, insomnia and allergies/asthma, the latter a product that is especially popular in Japan. Such health-care items have been both overpriced and difficult to find here, while ordering from abroad can be complicated. At present, some 40 products, including a wide range of skin-care products, are available through Rexall Showcase International and others are gradually being added to the list. The company is especially recognized for its anti-aging and preventive health-care products.

Here in Japan, it is necessary sometimes to change the formulation of products to comply with the demanding requirements for marketing health-related goods. The careful manipulation of approved ingredients assures that the altered products have the same effectiveness as the products sold in other countries. And since companies are not allowed to make claims concerning possible benefits on labels, or even verbally, because in general the effectiveness of most supplements cannot yet be scientifically demonstrated, most labels are vague. That is why you often find statements suggesting that a medication is good for you if you are tired, or helpful if you work too hard.