WASHINGTON, United States (AFP) — Fresh off his presidential clash with Hillary Clinton, Donald Trump doubled down yesterday on criticism of a former Miss Universe he accused of getting too fat, comments that could repel women voters.

Alicia Machado, who won the crown in 1996, has accused Trump — whose company owned the Miss Universe pageant until last year — of calling her “Miss Piggy” and “Miss Housekeeping,” and publicly humiliating her over her post-victory weight gain.

The morning after Clinton invoked Machado’s experience as an example of how the brash billionaire treats women, he lashed out at the beauty queen.

“She gained a massive amount of weight, and it was a real problem,” Trump told Fox television yesterday.

“She was the worst we ever had. The worst, the absolute worst,” he added. “She was impossible.”

Clinton had raised Machado’s case during a debate exchange over Trump’s assertion that the Democratic candidate did not “look presidential”.

Excoriating Trump for his treatment of women, she recalled that he had called Machado “Miss Piggy,” and “Miss Housekeeping” because she is Latina.

“Donald, she has a name. Her name is Alicia Machado. And she has become a US citizen, and you can bet she’s going to vote this November.”

Trump appeared startled by the accusation.

“Where did you find this?” Trump asked Clinton three times.

Shortly after the debate, Clinton’s campaign released a video in which Venezuelan-born Machado says she was scared of and intimidated by Trump.

“He’d yell at me all the time. He’d tell me ‘You look ugly,’ or ‘You look fat,’” she says.

“He bears many grudges, and harbours a deep racism, and he is convinced that there are lesser human beings than him.”

Trump is seen in 1990s footage saying Machado “weighed 118 pounds or 117 pounds (53 kilograms) and she went up to 160 or 170 (72.5 or 77 kg). So this is somebody that likes to eat.”

Throughout his campaign Trump has faced intense scrutiny over his treatment of women, and Clinton assailed her rival on the issue.

“This is a man who has called women pigs, slobs and dogs, and somebody who has said pregnancy is an inconvenience to employers, who has said women don’t deserve equal pay unless they do as good a job as men,” Clinton said.