Alicia Machado and Donald Trump
Miss Universe Alicia Machado, 19, smiles and makes the best of it in 1997 during one of her forced workouts in front of the press at Donald Trump's insistence.Reuters/Peter Morgan

Donald Trump's 'female problems' popped up afresh following his first presidential debate when a Latina woman he had called "Miss Piggy" bashed the candidate — and Trump hit back.

Former Miss Universe Alicia Machado became a mini-celebrity all over again when she starred in a Hillary Clinton debate point.

Clinton criticised Trump in the debate for calling women names, including calling Machado Miss Piggy when she gained weight after winning the crown in Trump's 1996 Miss Universe pageant. He also dismissed her as Miss Housekeeping because she was Latina, said Clinton.

"Donald, she has a name. Her name is Alicia Machado. And she has become a US citizen and you can bet she is going to vote this November," crowed Clinton.

Trump, apparently incredulous, asked repeatedly: "Where did you find this?"

Machado told CNN she was so moved to hear her story in the debate that she started crying.

"I know very well what's he's capable of, this man. And that's why I am fighting to make the community understand," she added.

Trump's response? "She gained a massive amount of weight," he said — again — the morning after the debate on Fox and Friends. He did not deny calling her Miss Piggy or Miss Housekeeping.

"She was the winner and she gained a massive amount of weight and it was a real problem," he said in a phone call to the programme.

"Not only that, her attitude. And we had a real problem with her. So Hillary went back into the years ... and found the girl and talked about her like she was Mother Teresa, and it wasn't quite that way, but that's okay."

Trump also grumbled in his phone call that Clinton in the debate "hit me at the end with the women," Trump said, referring to Clinton's criticism of his body-shaming insults about Rosie O'Donnell and others. "I was going to hit her with her husband's women, and I decided I shouldn't do it."

Machado has said that when she gained 15 pounds after winning Miss Universe, the real estate mogul repeatedly fat-shamed her. Trump insisted on accompanying her to the gym and made her work out in front of of gaggle reporters and cameramen.

"This is somebody who likes to eat," guffawed Trump on a video to reporters as he watched in a suit as Machado worked out.

Machado, who grew up in Venezuela, said she struggled afterward for years with eating disorders and psychological trauma as a result of the humiliation.

Now Machado hopes her story will have an impact on voters.

"I'm not beauty queen, I'm not Miss Universe anymore. I'm a worker, I'm a mother," she told NBC. "I have a family, I have a career, I have a business. If my story can open eyes for this election that is what I'm trying to do."

As for Trump, she told the Guardian: "He can't be president of the United States."

And in a translated Tweet she said: "My freedom of opinion is what I most love about being a US citizen! My position is overwhelmingly and firmly: #NaziRat you won't be president!"