Fructose and Liver Diseases in Youth: Help Them FLY

Inclusion Criteria: * obese boys and girls aged 12-18 years (Tanner Stage: III-V) with clinically diagnosed NAFLD Exclusion Criteria: 1. all patients with a history of a known primary liver disease associated with steatohepatitis (Wilson disease, various metabolic disorders, viral hepatitis) (7); 2. All patients with a known primary diagnosis of Type 2 Diabetes or those on insulin; 3. Patients on medications known to cause hepatic steatosis (e.g., methotrexate, corticosteroids, valproic acid, statins); 4. Patients with evidence of bridging fibrosis (8); and 5. Patients with a known significant history of smoking or alcohol consumption (6, 9) and 6. Any patient undergoing an active weight loss program and/or who has received bariatric surgery for the treatment of obesity 7. Any participant with a cardiac pacemaker or with metal pins as this is a contraindication for MRS/MRI testing 8. Any participant of child bearing potential who is known to be pregnant (as this is a contraindication to MRS/MRI) testing. All females of child bearing potential will be asked to undergo a routine pregnancy test (urine) prior to MRS/MRI testing. This will be conducted in the baseline study visit 9. Any child with significant developmental delay or a significant co-morbidity that precluded the ability to participate in study procedures