Most importantly; before anything else; as the primary consideration.
This phrase combines two words meaning 'first' for emphasis, dating back to Middle English. 'Foremost' originally meant 'most advanced in position,' and the pairing creates a emphatic redundancy common in English.
This is a classic example of a 'doublet' - pairing two words with similar meanings for emphasis, like 'safe and sound' or 'tried and true.' It shows how English loves redundancy when we really want to stress a point!
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