Inclusion Criteria:  Male or female patients who are 10 -17 years of age BMI greater than or equal to the 85th percentile Clinical serum triglyceride level >150 mg/dl and < 500 mg/dl performed between 3 months and 1 week prior to study visit 1 Ability to follow the study procedures and adhere to the diet counseling recommendations Written parental permission and assent are obtained prior to any research procedures  Exclusion Criteria:  Type 2 DM (hemoglobin A1C >6.6%) Isotretinoin use Chronic kidney disease (CKD) Uncontrolled hypothyroidism Warfarin use Liver disease (NAFLD is allowed) Renal disease Corticosteroid use Omega-3 fatty acid use (prescription or supplement) Allergy to fish and/or nuts Currently pregnant or planning to become pregnant during the course of this trial - confirmed by date of LMP/querying family Any significant medical condition which the investigator believes would interfere with participation in this study