School feeding programs are beneficial for the physical, mental, and psychosocial development of school-age children and adolescents, particularly those in low- and middle-income countries (LMICs). While school feeding programs are ubiquitous in LMICs, the specific benefits of school feeding programs are unclear. The aim of this systematic review and meta-analysis is to evaluate the impacts of school feeding programs on the educational and health outcomes of children and adolescents in LMICs. Rigorously designed interventional studies on the impacts of school feeding on nutritional and health outcomes of children and adolescents receiving primary or secondary education in LMICs will be included. The following information sources were used to identify relevant published or unpublished studies: MEDLINE, EMBASE, CINAHL, the Cochrane Library, and governmental or organizational websites. The risk of bias of randomized and non-randomized studies will be assessed using the Cochrane Risk of Bias tool and the ROBINS-I tool, respectively. Two reviewers will independently conduct the selection of studies, data extraction, and assessment of the risk of bias. A narrative synthesis of all the included studies will be provided. Meta-analyses will be performed whenever appropriate. Heterogeneity of effects will be assessed by I2, subgroup analyses, and meta-regression. The certainty of evidence for each outcome will be assessed using the Grading of Recommendation, Assessment, Development, and Evaluation (GRADE) approach. The design and implementation of school feeding programs in LMICs should be based on the understanding of the benefits of such programs. This work will provide a crucial evidence base for the educational and health benefits of school feeding on children and adolescents in LMICs. This protocol was submitted for registration with the International Prospective Register of Systematic Reviews (PROSPERO) on November 18, 2019 (registration number: pending).

中文翻译：

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中低收入国家学校供餐对学龄儿童和青少年教育和健康状况的影响：系统评价和荟萃分析的方案

学校供餐计划对于学龄儿童和青少年，特别是中低收入国家（LMIC）的学龄儿童和青少年的身体，心理和社会心理发展是有益的。虽然中低收入国家普遍存在学校供餐计划，但尚不清楚学校供餐计划的具体好处。该系统评价和荟萃分析的目的是评估学校供餐计划对中低收入国家儿童和青少年教育和健康状况的影响。将包括严格设计的干预研究，这些研究涉及学校供餐对在中低收入国家中接受初等或中等教育的儿童和青少年的营养和健康状况的影响。以下信息来源用于识别相关的已发表或未发表的研究：MEDLINE，EMBASE，CINAHL，Cochrane图书馆，和政府或组织的网站。将分别使用Cochrane偏倚风险工具和ROBINS-I工具评估随机和非随机研究的偏倚风险。两名审稿人将独立进行研究选择，数据提取和偏倚风险评估。将提供所有纳入研究的叙述性综合。只要适当，将进行荟萃分析。效果的异质性将通过I2，亚组分析和meta回归进行评估。每个结果的证据确定性将使用“建议，评估，发展和评估分级”（GRADE）方法进行评估。中低收入国家的学校供餐计划的设计和实施应基于对此类计划的好处的理解。这项工作将为中低收入国家为儿童和青少年提供学校供餐的教育和健康益处提供重要的证据基础。该协议已于2019年11月18日提交国际注册系统评价国际预期注册（PROSPERO）进行注册（注册号：待定）。